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美国低收入家庭儿童口腔健康服务利用情况的预测因素:观念、成本还是医疗服务提供者?

Predictors of the utilization of oral health services by children of low-income families in the United States: beliefs, cost, or provider?

作者信息

Kim Young Ok Rhee, Telleen Sharon

机构信息

College of Nursing, University of Illinois at Chicago, Illinois 60612, USA.

出版信息

Taehan Kanho Hakhoe Chi. 2004 Dec;34(8):1460-7. doi: 10.4040/jkan.2004.34.8.1460.

Abstract

PURPOSE

This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider.

METHODS

In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist.

RESULTS

The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on weekends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist.

CONCLUSION

The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

摘要

目的

本研究在经济障碍、观念以及医疗服务提供者层面,考察了促使儿童获得口腔保健服务的预测因素。

方法

对320名低收入家庭的移民母亲进行了深入访谈,了解她们为4至8岁儿童使用口腔健康服务的情况。通过计划就诊频率、连续护理情况以及首次看牙医的年龄来衡量获得口腔保健服务的情况。

结果

如果母亲从儿科医生处获得了牙医转诊,会在孩子更小的时候带其看牙医。定期看牙与家庭收入、周末医疗服务提供者的可及性以及保险覆盖情况显著相关。延长的晚间门诊时间以及认为孩子定期看牙医很重要的观念增加了持续接受护理的可能性。认为孩子牙科护理有费用负担的母亲再次看牙的可能性也较小。

结论

现有的医疗服务提供系统、协调的医疗护理以及健康观念是医疗服务利用的重要预测因素。研究结果表明,需要开展具有文化胜任力的口腔健康干预措施,以增加韩国社区低收入儿童等特别弱势群体获得口腔保健服务的机会。

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