Preventive and Community Dentistry, University of Iowa College of Dentistry, 343 Dental Science Building North, Iowa City, IA 52242-1010, USA.
J Public Health Dent. 2010 Fall;70(4):276-84. doi: 10.1111/j.1752-7325.2010.00182.x.
The purpose of this study was to identify which underserved populations are being treated by dentists after participation in community-based clinical rotations as dental students and to determine which predictor variables are associated with dentists' treatment of these populations.
A 25-item written survey was developed and mailed to University of Iowa College of Dentistry alumni (1992-2002; N = 745) to assess what percentage of their current total patient population was composed of each of the twelve identified populations. Separate statistical analyses (descriptive, bivariate, and generalized logistic regression) were performed for each underserved population.
Three-hundred seventy-two dentists responded for an adjusted response rate of 50 percent. Respondents were most likely to treat "other ethnic groups" and low income populations. In contrast, 70 percent or more of all respondents said they never treat the homebound, homeless, and incarcerated. Additionally, over 40 percent of respondents said they never treat HIV+/AIDS patients and Medicaid patients. Logistic regression models showed that comfort in treating a population, treating more than seven populations, and having the total percentage of underserved populations treated within a practice total more than 50 percent were the most frequently associated (P < 0.05) and strongest predictors of treating the listed underserved populations.
Although respondents reported treating most populations, community leaders and dentists should identify at-risk populations and develop protocols to help ensure that these populations are able to obtain, at a minimum, emergency care. Additionally, dental schools should develop educational curricula to help increase students' comfort in treating underserved populations.
本研究旨在确定参与社区临床轮转的牙医在毕业后会为哪些服务不足的人群提供治疗，并确定哪些预测变量与牙医为这些人群提供治疗相关。
开发了一份包含 25 个项目的书面调查问卷，并邮寄给爱荷华大学牙科学院的校友（1992-2002 年；N=745），以评估他们当前总患者群体中每一个确定的服务不足人群所占的比例。对每个服务不足的人群分别进行了统计分析（描述性、双变量和广义逻辑回归）。
372 名牙医做出了回应，调整后的回应率为 50%。受访者最有可能治疗“其他族裔”和低收入人群。相比之下，超过 70%的受访者表示他们从不治疗居家、无家可归和被监禁的人。此外，超过 40%的受访者表示他们从不治疗 HIV+/艾滋病患者和医疗补助患者。逻辑回归模型显示，治疗人群的舒适度、治疗超过七个人群，以及在实践中治疗的服务不足人群的总比例超过 50%，是治疗所列服务不足人群最常相关（P<0.05）和最强的预测因素。
尽管受访者报告称治疗了大多数人群，但社区领导人和牙医应确定处于危险中的人群，并制定协议，以帮助确保这些人群至少能够获得紧急护理。此外，牙科学院应制定教育课程，以帮助增加学生治疗服务不足人群的舒适度。
