Factors influencing perceived need for dental care by United States military recruits

This study explores factors that influence perceived need for dental care among US military recruits. The data were collected on a systematic random sample of 2711 US Army, Air Force, Navy, and Marine Corps recruits between February and July 1994. Participants received a comprehensive oral examination from a dentist and answered perceived need queries on self-administered questionnaires. Using bivariate and logistic regression analyses, we examined the association between demographic and clinical measures and perceived need for dental care. Bivariate results show that, overall, 61% of US military recruits perceive a need for dental care, with statistically significant differences across many demographic and clinical factors. Logistic regression results show that the likelihood of perceived need is influenced by gender, branch of service, dental health class, home region of the US, calculus, bleeding gums, level of decay, and dental utilization. Received: 17 December 1996 / Accepted: 24 November 1997     

Modified IOTN: an orthodontic treatment need index for use in oral health surveys

This paper reports the results of a study of the reliability of a modified version of the Index of Orthodontic Treatment Need (IOTN) for use in oral health surveys. Twelve non-specialist dental examiners were trained in the use of the Modified IOTN using a standardised teaching protocol lasting approximately 1.5 hours. Following a school-based calibration exercise it was found that nearly all the examiners achieved either good or excellent agreement (mean Kappa=0.74). The average sensitivity and specificity scores were 0.90 and 0.84, respectively. The Modified IOTN appears to overcome the training and reliability problems that often accompany the use of orthodontic indices by non-specialists in oral health surveys.     

Relationship between oral hygiene practices and oral status in dentate elderly people living in residential homes

OBJECTIVES: To investigate the relationship between the oral hygiene practices of dentate elderly people living in residential homes, their requests for assistance and their oral health status. METHODS: 164 people (81.2+/-7.4 years) participated in an interview and oral examination, and provided a stimulated saliva sample. RESULTS: The mean number of coronal decayed surfaces (CDS) was 2.4+/-5.9, stimulated salivary levels (log(10)cfu/ml) of mutans streptococci, lactobacilli and yeasts were 1.6+/-2.1, 3.0+/-2.2, 2.1+/-1.7, respectively, and 53% had root decayed surfaces (RDS). Plaque (PI) and gingival (GI) Indices were 2.3+/-0.7 and 1.6+/-0.4 and denture debris scores (DDS) were high. 31% of the population cleaned their mouths twice daily without requesting help and they had significantly fewer yeasts, RDS, restorations on root surfaces, lower PI, GI (P<0.005) and DDS (P<0.0001) than the 69% who cleaned less often. 50% of those who cleaned less frequently requested assistance with oral hygiene but only 5% said that their carers supported them. Those residents who requested help had significantly higher levels of yeasts, lactobacilli (P<0.001), retained roots, DDS, RDS (P<0.005), PI and GI (P<0.0001). CONCLUSION: The elderly residents' perceived need for assistance with oral hygiene was related directly to oral hygiene status and to clinical indicators of mucosal and dental diseases.     

Distribution of orthodontic services in Norway

Grytten J, Skau I, Stenvik A. Distribution of orthodontic services in Norway. Community Dent Oral Epidemiol 2010; 38: 267–273. © 2010 John Wiley & Sons A/S Abstract – Background and objectives: There is a lack of studies that have evaluated how different ways of organizing and financing orthodontic services perform with respect to access to care, and the cost of care. In Norway, orthodontic services for children and adolescents are partly financed by the state, and the size of the state subsidy depends on the severity of the malocclusion. Orthodontists have the freedom to establish a practice where they wish. The aim of this study was to examine whether there are inequalities with respect to access to orthodontic services in Norway, and to study the development of costs of the services from 2004 to 2007. Methods: Data on mean waiting time for starting treatment and working hours in practice were collected using a questionnaire that was sent to all the orthodontists in the country (n = 165). The response rate was 74%. The number of patients who received treatment according to different criteria of need was recorded from data in each practice. Information about the development of costs for orthodontic treatment was obtained from the National Insurance Administration. Results: In almost all the areas, waiting time for starting treatment was within clinically acceptable limits, and there were only small differences in supply of orthodontic treatment in different areas. Patients with the greatest need were given priority over patients with the least need, which is in line with the aims of the authorities. In 2007 the reimbursements for orthodontic treatment from the National Insurance Administration amounted to Euro 48 million. In deflated prices this was virtually the same amount as in 2004. Conclusion: Our results show that the combination of public funding and freedom to establish a practice ensures that services are available for the individuals who are most in need of treatment. The authorities also have control over costs. The experiences from the orthodontic services in Norway are useful for policymakers in other countries. In particular, an important finding is that an orthodontic service where the state subsidy depends on the severity of the malocclusion can secure both equal access to the services and contain costs.     

某战区官兵健康状况调查

目的：了解官兵总体健康状况,指导部队卫生工作.对象采用了分阶段多级抽样方法,抽取了某战区3所医院保障体系2 600名官兵作为调查对象.方法：现场问卷调查.结果：总体健康水平提高,比国家平均水平仍有差距;不同军兵种官兵的健康状况存在差异.结论：应注重团以下干部的医疗保健,按不同军兵种实施差异化保障.     

Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over

Self-rated health (SRH) is a measure of perceived health that has been shown to predict use of community services, functional decline, pain, and mortality. Many factors associated with SRH have been identified, but unmet need for physical assistance with activities of daily living (ADL) has not yet been examined. The objective of this paper is to examine the association between unmet need and SRH while accounting for the effects of other, previously identified, correlates of SRH. We conducted a secondary analysis of a population-based study of 839 residents of Montréal, Québec who were 75 years of age or older, not cognitively impaired, and living in the community. Multivariable logistic regression was used to evaluate the association between met and unmet personal ADL (PADL) and instrumental ADL (IADL) need for physical assistance with SRH. Among 508 disabled community-dwelling elderly, for each additional unmet IADL need, subjects were 1.70 (95% CI: 1.11–2.61) times more likely to report poorer SRH. For each additional unmet PADL need, subjects were 2.26 (95% CI: 1.31–3.91) times more likely to report poorer SRH. Subjects at increased risk of malnutrition, with greater comorbidity and whose income was insufficient to meet their needs were also more likely to report poorer SRH. After adjustment for important correlates, unmet PADL and IADL needs retain a statistically significant association with poorer SRH, with nutritional status, comorbid conditions, and income satisfaction being important confounders of the relationship.     

综合性医院儿科住院患儿家属对医院需求的调查分析

目的调查综合性医院儿科住院患儿家属对医院的需求，寻求更人性化服务的方式。方法对255例住院患儿家长进行问卷调查。结果对医院设施和管理、对疾病相关内容的了解、对医生护士的要求、对健康教育进行了排序。结论根据排序的结果，寻求最需解决的问题来提高儿科住院患儿家长的满意度。     

医院慢性乙型肝炎患者健康知识需求及其对策

目的为了解医院门诊及住院慢性乙型病毒性肝炎（以下简称慢乙肝）患者健康知识需求及提高健康教育成效。方法采用自行设计的调查问卷表，分别对医院门诊及住院慢乙肝患者进行问卷调查。结果门诊患者对慢乙肝知识的认知情况明显差于住院患者，获取知识的途径比较局限；在健康教育方式需求上，住院及门诊患者均普遍选择医务人员的个别指导。结论应加强门诊健康教育的管理，同时要根据不同时期、不同患者的特点，采用多种健康教育方式相结合，全方位满足患者需求。     

上海市老年人家庭护理服务需求及支付意愿的质性研究

目的探讨上海市居家老年人家庭护理服务需求及支付意愿。方法采用质性研究中的现象学研究法,对10名居家老年人进行半结构式访谈,并运用Claizzi分析程序进行资料分析。结果居家老年人主要希望得到基础护理、康复护理、健康教育、家庭病床等专业化家庭护理服务和家政转介服务、精神慰藉等非专业化家庭护理服务,并存在一定支付意愿,但总体意愿支付值偏低,其中希望以项目形式进行收费者居多。结论老年人对家庭护理服务存在一定的需求及支付意愿,应大力拓展家庭护理服务,适当收费,促进卫生资源的合理分配及家庭护理的可持续发展。