Bedi Raman
Global Child Dental Health Taskforce, Kings College London, London, UK.
Community Dent Oral Epidemiol. 2006 Jun;34(3):222-4. doi: 10.1111/j.1600-0528.2006.00300.x.
Access to dental services because of an insufficient workforce is a historic challenge faced by many developing countries. In recent years, however, it has become a major issue for many industrialized countries. The growing demand for cosmetic dentistry, an increase in patients' willingness to pay for dental treatment, and growing numbers of older dentate patients have all put pressure on dental systems. Ways of meeting these challenges and ensuring reasonable dental access will vary from country to country, but the solutions often lie in how the dental workforce is regulated. This case study of the dental reforms currently being implemented in England highlights progress at a particular point in time (Summer 2005). It is clear that it will take a number of years to find a new national dental payment system (the National Health Service) to replace the system which has changed little since 1948. However, the political pressure to address poor access to state-funded dental services calls for more immediate actions. The initial approach was to increase the dental workforce via international recruitment, and in the medium term to increase the number of dental students in training and to expand the numbers of other members of the dental team. An additional stratagem is to retain those already providing dental care under the National Health Service by the introduction of a new method of remuneration. England is trying to improve both access to care and the oral health of the population by creating a workforce more suitable to public demands and changing oral health needs.
由于劳动力不足而难以获得牙科服务，这是许多发展中国家面临的一个历史性挑战。然而，近年来，这已成为许多工业化国家的一个重大问题。对美容牙科的需求不断增长、患者支付牙科治疗费用的意愿增加以及老年有牙患者数量的不断增加，都给牙科系统带来了压力。应对这些挑战并确保合理的牙科服务可及性的方式因国家而异，但解决方案往往在于如何对牙科劳动力进行监管。本关于英国目前正在实施的牙科改革的案例研究突出了特定时间点（2005年夏季）的进展情况。显然，要找到一个新的国家牙科支付系统（国民医疗服务体系）来取代自1948年以来变化不大的系统，还需要数年时间。然而，解决国家资助的牙科服务可及性差这一问题的政治压力要求采取更直接的行动。最初的方法是通过国际招聘增加牙科劳动力，并在中期增加接受培训的牙科学生数量，扩大牙科团队其他成员的数量。另一个策略是通过引入一种新的薪酬方法来留住那些已经在国民医疗服务体系下提供牙科护理的人员。英国正试图通过打造一支更适合公众需求和不断变化的口腔健康需求的劳动力队伍，来改善医疗服务可及性和民众的口腔健康状况。
