George Roslind Preethi, Kruger Estie, Tennant Marc
Centre for Rural and Remote Oral Health, The University of Western Australia, Crawley, Western Australia.
Oral Health Prev Dent. 2011;9(2):131-6.
The aim of the study was to test the hypothesis that all Australians based on clinical need have equal access to health services for the removal of impacted teeth as hospital in-patients.
Data for the current analysis were obtained from the Western Australian Hospital Morbidity Data System (HMDS) for the six financial years 1999/00 to 2004/05. All cases of in-hospital treatment for impacted teeth were analysed and then correlated with socioeconomic status, geographic location of the patients, place of primary residence, and age.
In-patient extraction rates are significantly higher in the 10- to 19-year-old and the 20- to 29-year-old age groups when compared to the other age groups. A young adult from a higher socioeconomic group is 4 times more likely to have an impacted tooth removed in a hospital than his or her counterpart from a lower socioeconomic group, which is significant. Similarly, people living in highly accessible metropolitan areas have a 3 times greater chance of being hospitalised for this procedure than those from the remote and rural areas.
There are significant differences among different groups based on socioeconomic status and access to health services for in-hospital removal of impacted teeth, thus rejecting the hypothesis. This raises doubts over the nature of the procedure, considering that most patients are young, non-Indigenous, and live in metropolitan areas. This implies that some of the procedures seem to be elective and there is a need for introduction of guidelines in Australia for removal of impacted teeth, which could reduce expenditures significantly. However, further research is required in this area.
本研究旨在验证以下假设：所有澳大利亚人根据临床需求，作为住院患者，在拔除阻生牙方面可平等获得医疗服务。
本次分析的数据来自西澳大利亚医院发病率数据系统（HMDS），涵盖1999/00至2004/05这六个财政年度。对所有住院治疗阻生牙的病例进行分析，然后将其与社会经济地位、患者地理位置、主要居住地点和年龄进行关联。
与其他年龄组相比，10至19岁和20至29岁年龄组的住院拔牙率显著更高。社会经济地位较高群体中的年轻人在医院拔除阻生牙的可能性是社会经济地位较低群体中同龄人4倍，这一差异具有显著性。同样，居住在交通便利的大都市地区的人因该手术住院的几率是偏远和农村地区居民的3倍。
基于社会经济地位以及住院拔除阻生牙获得医疗服务的情况，不同群体之间存在显著差异，因此该假设被否定。鉴于大多数患者为年轻的非原住民且居住在大都市地区，这引发了对该手术性质的质疑。这意味着某些手术似乎属于选择性手术，澳大利亚需要引入拔除阻生牙的指导方针，这可能会显著降低开支。然而，该领域还需要进一步研究。
