Skinner Asheley Cockrell, Slifkin Rebecca T, Mayer Michelle L
Department of Health Policy and Administration, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
J Rural Health. 2006 Winter;22(1):36-42. doi: 10.1111/j.1748-0361.2006.00008.x.
Unmet need for dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN), even though these children are at a greater risk for dental problems. The combination of rural residence and special health care needs may leave rural CSHCN particularly vulnerable to high levels of unmet dental needs.
To examine the effects of rural residence on unmet dental need for CSHCN.
We use the nationally representative National Survey of CSHCN Needs. We performed logistic regression to estimate the independent effects of rural residence on the likelihood of having an unmet dental need, using a measure of unmet need based on professional society recommendations and a measure based on parental report.
Using either of the measures, a substantial percentage of CSHCN do not receive all needed dental care. Rural CSHCN are more likely to forgo needed dental care than their urban counterparts. Our results suggest that rural CSHCN have unmet needs for dental care due to both difficulty accessing care and because their parents do not recognize a need.
Traditional access barriers for rural children, such as inadequate provider supply and lack of insurance, may increase unmet needs both directly and indirectly, through their effects on parents' perceptions of need. Reducing unmet needs for dental care in rural children with special needs will require addressing both access issues and parents' understanding of dental care need.
尽管有特殊医疗需求的儿童（CSHCN）患牙科问题的风险更高，但牙科护理需求未得到满足是他们中最普遍的未满足的医疗保健需求。农村居住和特殊医疗需求相结合，可能使农村CSHCN特别容易面临高水平的未满足牙科需求。
研究农村居住对CSHCN未满足牙科需求的影响。
我们使用具有全国代表性的CSHCN需求全国调查。我们进行了逻辑回归，以估计农村居住对有未满足牙科需求可能性的独立影响，使用基于专业协会建议的未满足需求衡量标准和基于家长报告的衡量标准。
无论使用哪种衡量标准，很大比例的CSHCN都没有得到所有所需的牙科护理。农村CSHCN比城市CSHCN更有可能放弃所需的牙科护理。我们的结果表明，农村CSHCN存在未满足的牙科护理需求，原因既有获得护理的困难，也有其父母未认识到需求。
农村儿童面临的传统就医障碍，如医疗服务提供者供应不足和缺乏保险，可能通过影响父母对需求的认知，直接或间接地增加未满足的需求。减少农村特殊需求儿童未满足的牙科护理需求将需要解决就医问题和父母对牙科护理需求的理解。
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