Balogh Robert S, Ouellette-Kuntz Hélène, Hunter Duncan J W
International Centre for the Advancement of Community-Based Rehabilitation, Queen's University, Kingston, Ontario.
J Can Dent Assoc. 2004 Nov;70(10):681, 681a-681f.
The literature indicates that people with an intellectual disability have a prevalence of dental caries that is either lower than or similar to that of the general population. However, many of their caries go untreated, and extractions are more often used as a means of treatment than in the general population. A substantial percentage (40%) of day admissions to hospital of people with intellectual disabilities in Ontario is related to dental diseases. In this paper, we examine whether rates of in-hospital dental procedures are evenly distributed across Ontario and discuss possible explanations for the findings.
A retrospective analysis was made of routinely collected hospital admission data for people with an intellectual disability. Age- and gender-adjusted rates for dental procedures were calculated using the direct method of adjustment and 1996 census population estimates of Ontario. Three different summary measures for the assessment of regional variation were used.
Two areas had dental procedure rates among those with an intellectual disability that were significantly lower than the overall Ontario rate: Hamilton-Wentworth and Quinte-Kingston and Rideau. The 3 district health council areas with the highest rates for dental procedures were Niagara, Essex-Kent and Lambton, and Durham-Haliburton-Kawartha and Pine Ridge; all 3 rates were higher than the overall Ontario rate.
The use of day surgery and in-hospital visits to treat dental diseases in people with an intellectual disability varies considerably by region in Ontario. Observed differences may indicate inequities.
文献表明,智障人士的龋齿患病率低于或与普通人群相似。然而,他们的许多龋齿未得到治疗,而且与普通人群相比,拔牙作为一种治疗手段的使用更为频繁。安大略省智障人士日间住院的很大一部分比例(40%)与牙科疾病有关。在本文中,我们研究了安大略省医院内牙科手术的发生率是否在全省均匀分布,并讨论了这些发现的可能解释。
对智障人士常规收集的医院入院数据进行回顾性分析。使用直接调整法和安大略省1996年人口普查人口估计数计算年龄和性别调整后的牙科手术发生率。使用了三种不同的区域差异评估汇总指标。
有两个地区智障人士的牙科手术发生率显著低于安大略省总体发生率:汉密尔顿-温特沃斯地区以及昆特-金斯敦和里多地区。牙科手术发生率最高的三个地区卫生委员会区域是尼亚加拉地区、埃塞克斯-肯特和兰伯顿地区,以及达勒姆-哈利伯顿-卡沃萨和派恩里奇地区;所有这三个地区的发生率均高于安大略省总体发生率。
安大略省不同地区在使用日间手术和住院治疗智障人士牙科疾病方面存在很大差异。观察到的差异可能表明存在不公平现象。