Gilbert Gregg H, Shelton Brent J, Duncan R Paul
Department of Diagnostic Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
Community Dent Oral Epidemiol. 2002 Aug;30(4):260-76. doi: 10.1034/j.1600-0528.2002.00047.x.
To (a) describe the incidence of use of specific dental services; (b) test the hypothesis that certain predisposing, enabling, and need (PEN) factors are differentially predictive of service use; and (c) test the hypothesis that even with other PEN factors taken into account, race and household income are differentially predictive of certain dental services. Previously, this study identified PEN factors that predicted use of any care; herein we identify whether these same factors were differentially predictive of specific service use among users of at least one service.
The Florida Dental Care Study was a longitudinal study of persons aged 45 years or older who had at least one tooth. Subjects participated for interviews and clinical examinations at baseline and 24 months later, with 6-monthly telephone interviews between those times.
Seventy-seven percent of subjects reported one or more visits. Results from a single multivariate multiple logistic regression suggested that even once analysis was limited to persons who used at least one dental service, at least one measure from each of the PEN domains was predictive of specific dental service use.
Each PEN domain was predictive of service use, even once limited to persons with at least one visit. Even with differences in other PEN variables taken into account, African-Americans were much less likely to receive dental cleanings, restorative dentistry and fixed prosthodontic services, and were much more likely to have a tooth extracted. Household income was predictive of receipt of fixed prosthodontic services, but not other service categories.
(a) 描述特定牙科服务的使用发生率;(b) 检验某些 predisposing、enabling 和需求(PEN)因素对服务使用具有不同预测性这一假设;(c) 检验即使考虑了其他 PEN 因素,种族和家庭收入对某些牙科服务仍具有不同预测性这一假设。此前,本研究确定了预测任何护理使用情况的 PEN 因素;在此我们确定这些相同因素是否对至少使用过一项服务的人群中特定服务的使用具有不同的预测性。
佛罗里达牙科护理研究是一项针对 45 岁及以上至少有一颗牙齿的人群的纵向研究。受试者在基线时和 24 个月后参加访谈和临床检查,在此期间每 6 个月进行一次电话访谈。
77%的受试者报告有一次或多次就诊。单一多元多项逻辑回归的结果表明,即使分析仅限于使用过至少一项牙科服务的人群,每个 PEN 领域的至少一项指标仍可预测特定牙科服务的使用情况。
每个 PEN 领域都可预测服务使用情况,即使仅限于至少就诊过一次的人群。即使考虑到其他 PEN 变量的差异,非裔美国人接受牙齿清洁、修复牙科和固定义齿修复服务的可能性要低得多,而拔牙的可能性要高得多。家庭收入可预测固定义齿修复服务的接受情况,但对其他服务类别则不然。