Brennan David S, Luzzi Liana, Roberts-Thomson Kaye F
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, South Australia 5005, Australia.
BMC Health Serv Res. 2008 Jan 3;8:1. doi: 10.1186/1472-6963-8-1.
While the majority of dental care in Australia is provided in the private sector those patients who attend for public care remain a public health focus due to their socioeconomic disadvantage. The aims of this study were to compare dental service profiles provided to patients at private and public clinics, controlling for age, sex, reason for visit and income.
Data were collected in 2004-06, using a three-stage, stratified clustered sample of Australians aged 15+ years, involving a computer-assisted telephone interview (CATI), oral examination and mailed questionnaire. Analysis was restricted to those who responded to the CATI.
A total of 14,123 adults responded to the CATI (49% response) of whom 5,505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. Multivariate analysis controlling for age, sex, reason for visit and income showed that persons attending public clinics had higher odds [Odds ratio, 95%CI] of extraction (1.69, 1.26-2.28), but lower odds of receiving oral prophylaxis (0.50, 0.38-0.66) and crown/bridge services (0.34, 0.13-0.91) compared to the reference category of private clinics.
Socio-economically disadvantaged persons who face barriers to accessing dental care in the private sector suffer further oral health disadvantage from a pattern of services received at public clinics that has more emphasis on extraction of teeth and less emphasis on preventive and maintenance care.
在澳大利亚,虽然大多数牙科护理是由私营部门提供的,但由于社会经济劣势,那些接受公共护理的患者仍然是公共卫生关注的焦点。本研究的目的是比较在私立和公立诊所提供给患者的牙科服务概况,同时控制年龄、性别、就诊原因和收入。
在2004 - 06年收集数据,采用三阶段分层整群抽样,对象为15岁及以上的澳大利亚人,包括计算机辅助电话访谈(CATI)、口腔检查和邮寄问卷。分析仅限于那些对CATI做出回应的人。
共有14,123名成年人对CATI做出了回应(回应率为49%),其中5,505人(占受访者的44%)同意接受口腔流行病学检查。在控制年龄、性别、就诊原因和收入的多变量分析中,与私立诊所的参考类别相比,在公立诊所就诊的人拔牙的几率更高[优势比,95%置信区间](1.69,1.26 - 2.28),但接受口腔预防治疗(0.50,0.38 - 0.66)和牙冠/牙桥服务(0.34,0.13 - 0.91)的几率更低。
在私营部门获得牙科护理面临障碍的社会经济弱势群体,由于在公立诊所接受的服务模式更侧重于拔牙,而较少强调预防和维护护理,因此在口腔健康方面进一步处于劣势。