Health Management and Policy, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4162, USA.
J Public Health Dent. 2010 Fall;70(4):292-9. doi: 10.1111/j.1752-7325.2010.00184.x.
To examine past-year dental visits among underserved, Hispanic farm-worker families using the Andersen Behavioral Model of Health Services Utilization, which posits that predisposing, enabling, and need factors influence care-seeking behavior.
Oral health survey and clinical data were collected in 2006-2007 from families in Mendota, California (Fresno County) as part of a larger, population-based study. Generalized estimating equation logit regression assessed effects of factors on having a dental visit among adults (N = 326). Predisposing variables included sociodemographic characteristics, days worked in agriculture, self-rated health status, and dental beliefs. Enabling factors included resources to obtain services (dental insurance, income, acculturation level, regular dental care source). Need measures included perceived need for care and reported symptoms, along with clinically determined untreated caries and bleeding on probing.
Only 34% of adults had a past-year dental visit, despite 44% reporting a regular dental care source. Most (66%) lacked dental insurance, and nearly half (46%) had untreated caries. Most (86%) perceived having current needs, and on average, reported a mean of 4.2 dental symptoms (of 12 queried). Regression analyses indicated those with more symptoms were less likely to have a past-year dental visit. Those who would ask a dentist for advice and had a regular dental care source were more likely to have a past-year dental visit.
The final model included predisposing, enabling, and need factors. Despite low utilization and prevalent symptoms, having a regular source of care helps break this pattern and should be facilitated.
利用安德森健康服务利用行为模式，考察服务不足的西班牙裔农场工人家庭过去一年的牙科就诊情况，该模式认为倾向因素、促成因素和需求因素影响着寻求医疗服务的行为。
2006-2007 年，在加利福尼亚州门多塔（弗雷斯诺县）的家庭中进行了口腔健康调查和临床数据收集，这是一项更大的基于人群的研究的一部分。使用广义估计方程对数回归评估了各种因素对成年人就诊（N=326）的影响。倾向因素包括社会人口特征、在农业部门工作的天数、自我评估的健康状况和对牙科的信念。促成因素包括获得服务的资源（牙科保险、收入、文化适应水平、定期牙科护理来源）。需求指标包括对护理的需求感知和报告的症状，以及临床确定的未治疗龋齿和探诊出血。
尽管有 44%的人报告有定期的牙科护理来源，但只有 34%的成年人在过去一年中有过牙科就诊。大多数（66%）人没有牙科保险，近一半（46%）人有未治疗的龋齿。大多数（86%）人认为自己有当前的需求，平均报告了 4.2 种牙科症状（共询问了 12 种）。回归分析表明，有更多症状的人不太可能在过去一年中有过牙科就诊。那些会向牙医咨询并拥有定期牙科护理来源的人更有可能在过去一年中有过牙科就诊。
最终模型包括倾向因素、促成因素和需求因素。尽管利用率低且症状普遍存在，但拥有定期的护理来源有助于打破这种模式，应加以促进。
