Richards Wayne, Razzaq Kamran, Higgs Gary
Faculty of Health Sport and Science, University of Glamorgan, Pontypridd, Wales, UK.
Prim Dent Care. 2009 Oct;16(4):143-7. doi: 10.1308/135576109789389441.
The aim of this audit was to quantify the number of patients that received a dental general anaesthetic (DGA) between 1999 and 2007 following referral from a general dental practice. It also aimed to establish the deprivation status of those referred and to investigate further dental treatment pathways of these patients.
Data were collected from all patient records held by the practice. The information collected included: postcode, gender, age at the close of the study, age at time of DGA, reason for DGA, number of teeth extracted, and details of further ongoing care. In the absence of individual level socioeconomic data, a deprivation score (derived from the Welsh Index of Multiple Deprivation [WIMD]) was appended to each record in order to provide a measure of deprivation based on the postcode of the patient.
Two hundred and eighty-seven patients were referred for DGA during the nine-year period. Their mean age was 9.4 years (95% confidence interval [CI] = 8.4, 10.4) and 30.7% were children aged five years or younger. The most common reason for DGA was dental caries. The mean number of teeth extracted was 4.5 (95% CI = 4.1, 4.9). Patients living in deprived areas were more likely to be referred for DGA. Of the 87 who did not subsequently attend for continuing care, 72 were from deprived areas compared with 15 from more affluent areas (P=0.003).
In proportion to the number of patients registered at a practice, the number of referrals for DGAs was relatively low. Patients categorised as deprived (based on their residential postcode) received more referrals for DGAs than those from more affluent areas. Patients from deprived locations were significantly more likely not to attend for continuing care after their DGA than those from more affluent areas.
本次审核的目的是量化1999年至2007年间从普通牙科诊所转诊后接受牙科全身麻醉（DGA）的患者数量。它还旨在确定被转诊患者的贫困状况，并调查这些患者进一步的牙科治疗途径。
从该诊所保存的所有患者记录中收集数据。收集的信息包括：邮政编码、性别、研究结束时的年龄、接受DGA时的年龄、DGA的原因、拔牙数量以及进一步持续护理的细节。由于缺乏个体层面的社会经济数据，为每条记录附加了一个贫困分数（源自威尔士多重贫困指数[WIMD]），以便根据患者的邮政编码提供贫困程度的衡量标准。
在九年期间，有287名患者被转诊接受DGA。他们的平均年龄为9.4岁（95%置信区间[CI]=8.4，10.4），30.7%为5岁或以下的儿童。DGA最常见的原因是龋齿。平均拔牙数量为4.5颗（95%CI=4.1，4.9）。生活在贫困地区的患者更有可能被转诊接受DGA。在87名随后未接受持续护理的患者中，72名来自贫困地区，而15名来自较富裕地区（P=0.003）。
与诊所登记的患者数量相比，DGA转诊的数量相对较低。被归类为贫困的患者（基于其居住邮政编码）比来自较富裕地区的患者接受更多的DGA转诊。来自贫困地区的患者在接受DGA后不参加持续护理的可能性明显高于来自较富裕地区的患者。
