Heloe L A, Heloe B
Nor Tannlaegeforen Tid. 1975 Sep;85(8):296-303.
Since 1950, the Public Dental Service (PDS) has gradually been developed in Norway. In addition to rendering free and systematic treatment to children aged 6--17 years, which has priority, the PDS also offers treatment to other categories of patients at fixed fees, generally lower than those in private practice. The purpose of the present study was to elucidate the impact made by PDS on the dental treatment pattern within one particular area (the district of Harstad with a population of approximately 29,000). Furthermore, the study included a description of the clientele in the PDS, excluding the "free clientele" aged 6--17, in relation to that treated in private practice. During a limited period in February--March 1974, all the 9 dentists in the PDS treating "paying clientele" and all the 9 private practitioners in the district, filled in a questionnaire by each patient visit (course of treatment) (Fig. 1). In addition to the information on social and demographic characteristics, data were also collected on dental treatment pattern, the treatment presently rendered, and the presence of teeth and possible dentures (Fig. 1). Four--fifths of the visits made by "paying clientele" were made in private practice, only one--fifth in the PDS. In private practice, rural people, women and people of young age were underrepresented. Children under 6 years of age comprised 3% of the clientele in private practice and 9% in the PDS. No significant difference was found between the two types of practice regarding the social class composition of the clientele. Dental status as measured by the occurrence of teeth and dentures was generally poorer among the PDS patients, seemingly due to the overweight of rural people and of those with an irregular or occasional treatment pattern. Totally 40% of all visits were made by regular treatment attenders. 20% of the services delivered were prophylaxes and/or periodontics, 56% were conservative and/or endodontic treatments. The introduction of the FDS in the district some 10--15 years ago has conceivably contributed to an overall increase in the demand for dental services, and to an improvement of denial treatment patterns. During this period, the number of public dentists has increased from 2--3 to a total of 12. Correspondingly, the number of private practitioners has increased from 5 to 9, of whom 2 work part time. The treatment attendance of some population subgroups is, however, still lagging behind: rural people, small children and persons over 50 years of age, and particularly people belonging to lower socio-economic brackets.
自1950年以来，挪威逐步发展了公共牙科服务（PDS）。除了优先为6至17岁的儿童提供免费且系统的治疗外，PDS还以固定费用为其他类别的患者提供治疗，这些费用通常低于私人诊所的收费。本研究的目的是阐明PDS对一个特定地区（哈斯塔德区，人口约29000）内牙科治疗模式的影响。此外，该研究还描述了PDS中的客户群体（不包括6至17岁的“免费客户群体”）与私人诊所治疗的客户群体之间的关系。在1974年2月至3月的有限时间段内，PDS中治疗“付费客户群体”的所有9名牙医以及该地区的所有9名私人执业医生，在每次患者就诊（治疗过程）时填写了一份问卷（图1）。除了社会和人口特征信息外，还收集了有关牙科治疗模式、当前进行的治疗以及牙齿和假牙情况的数据（图1）。“付费客户群体”五分之四的就诊是在私人诊所进行的，只有五分之一是在PDS进行的。在私人诊所中，农村人口、女性和年轻人的比例较低。6岁以下儿童在私人诊所的客户群体中占3%，在PDS中占9%。在客户群体的社会阶层构成方面，两种类型的诊所之间未发现显著差异。从牙齿和假牙的情况衡量，PDS患者的牙齿状况总体较差，这似乎是由于农村人口以及治疗模式不规律或偶尔接受治疗的人群占比过高。所有就诊中，40%是由定期接受治疗的患者进行的。提供的服务中，20%是预防和/或牙周治疗，56%是保守和/或牙髓治疗。大约10至15年前该地区引入PDS，可能促使牙科服务需求总体增加，并改善了牙科治疗模式。在此期间，公立牙医的数量从2至3名增加到了总共12名。相应地，私人执业医生的数量从5名增加到了9名，其中2名兼职工作。然而，一些人群亚组的治疗就诊率仍然滞后：农村人口、幼儿和50岁以上的人群，特别是社会经济地位较低的人群。
