Hussein R J, Schneller T, Dierks M-L, Walter U
Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover.
Gesundheitswesen. 2013 Nov;75(11):e161-7. doi: 10.1055/s-0032-1331787. Epub 2013 Apr 2.
Dentists' suggestions for the establishment of preventive care were investigated on 3 levels; dentist, dental associations and unions (DAU), and health care system (HCS). Associations between categories of suggestions and dentists' characteristics were explored.
A postal survey was sent to 2,075 dentists practicing in Bremen and Lower Saxony. The answers on 3 open-ended questions were analysed in a qualitative manner based on the quality control protocol (QCP) of the Federal Joint Committee. Quantitative methods were used for exploring associations between categories of suggestions and gender as well as age.
Response rate was 33% (n=685). Dentists made 2,120 suggestions (dentist=752, DAU= 574, HCS= 794). The majority of dentists (90%) suggested educating and motivating patients. Dentists stated that support from DAU is needed in educating the public (50%), offering preventive-oriented training (35%), and in advertising for prophylaxis (18%). On the HCS level, about 60% of the suggestions concerned remunerating prophylaxis and expanding the existing bonus system. Significantly more female (p=0.010) and younger dentists (p=0.031) contributed to educating patients than male and older dentists.
Education is the key message of this work. Essential topics such as prevention for elderly and risk groups were not a focal point. Education on the DAU and HCS levels can be realised through organising nation-wide health campaigns. Funding options for prevention and regulating multidisciplinary work between dentists and other health-care providers should be examined. These changes can contribute enormously to further establish prevention.
从三个层面调查牙医对建立预防保健的建议，这三个层面分别是：牙医个人、牙科协会和工会（DAU）以及医疗保健系统（HCS）。探讨建议类别与牙医特征之间的关联。
向在不来梅和下萨克森州执业的2075名牙医邮寄了调查问卷。根据联邦联合委员会的质量控制协议（QCP），以定性方式分析了对三个开放式问题的回答。采用定量方法探讨建议类别与性别以及年龄之间的关联。
回复率为33%（n = 685）。牙医提出了2120条建议（牙医个人=752条，DAU = 574条，HCS = 794条）。大多数牙医（90%）建议对患者进行教育和激励。牙医表示，在对公众进行教育（50%）、提供预防导向的培训（35%）以及预防宣传（18%）方面需要DAU的支持。在HCS层面，约60%的建议涉及预防保健的薪酬支付和扩大现有的奖励制度。与男性和年长牙医相比，女性牙医（p = 0.010）和年轻牙医（p = 0.031）在对患者进行教育方面的贡献显著更多。
教育是这项工作的关键信息。诸如针对老年人和风险群体的预防等重要主题并非重点。可以通过组织全国性的健康运动来实现DAU和HCS层面的教育。应研究预防保健的资金选择以及规范牙医与其他医疗保健提供者之间的多学科合作。这些变革能够极大地有助于进一步确立预防保健工作。
