Kinlaw D H
North Carolina State Board of Dental Examiners, USA.
J Dent Educ. 2001 Sep;65(9):849-60.
The present dilemma in providing dental services to the indigent and Medicaid recipients throughout this nation has generated considerable controversy as to the evolution of the problem. Most states recognize that there are deficiencies in the provision of dental services to these populations and are seeking resolutions. While state licensing board practices and dental professional society politics have been the object of criticism as contributing to if not causing of this problem, other rational and statistically valid explanations for the current difficulty exist. As an explanation for access to care issues, this paper explores the decline in the national numbers of dental practitioners and concomitant dental productivity. Furthermore, it relates those parameters to the dramatic rise in the utilization and demand for dental services resulting from a robust economy, population growth trends, and changes in state and federal Medicaid legislation that increase numbers of Medicaid-eligible recipients. While these general trends are national in scope and application, the state of North Carolina and its experience will be used to fully explore the impact of these trends at the state and local level.
目前，在为全国贫困人群和医疗补助受助者提供牙科服务方面存在的困境，引发了关于该问题演变的诸多争议。大多数州都认识到在为这些人群提供牙科服务方面存在不足，并正在寻求解决方案。虽然州许可委员会的做法和牙科专业协会的政策受到批评，被认为即便不是导致这一问题的原因，也是促成因素，但对于当前的困境也存在其他合理且基于统计有效的解释。作为对医疗服务可及性问题的一种解释，本文探讨了全国牙科从业者数量的下降以及随之而来的牙科医疗产出的下降。此外，还将这些参数与经济繁荣、人口增长趋势以及州和联邦医疗补助立法变化导致的牙科服务利用和需求急剧增加联系起来，这些变化使符合医疗补助资格的受助者数量增多。虽然这些总体趋势在全国范围内适用，但将以北卡罗来纳州及其经验来全面探讨这些趋势在州和地方层面的影响。
