Manski Richard J, Macek Mark D, Brown Erwin, Carper Kelly V, Cohen Leonard A, Vargas Clemencia
Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD, USA.
J Public Health Dent. 2014 Spring;74(2):102-9. doi: 10.1111/jphd.12032. Epub 2013 Aug 26.
In the United States, health-care costs are increasing while state and federal budgets contract. In order to establish a baseline and provide data for alternative oral health workforce models, this report describes the types of dental procedures received by US working-age adults in 2009 and looks at trends since 1999.
Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Surveys. The primary outcome variable represented the types of dental procedures undergone during a dental visit in the preceding year. Descriptive variables included dental insurance coverage and income. Analysis was restricted to adults aged 21-64 years.
In 2009, diagnostic and preventive procedures accounted for >75 percent of all dental services received by working-age adults. Those with public insurance and those who were uninsured, as well as those with lower income, were less likely to receive these services than their peers. Between 1999 and 2009, small but statistically significant increases in the proportion of preventive and diagnostic procedures received occurred in the nation. The likelihood that a preventive service would be received during a visit also increased during this period, while the probability that a restorative procedure would be undergone went down.
Preventive-type procedures represented the vast majority of dental services received by working-age adults in 2009. Between 1999 and 2009, receipt of preventive-type procedures generally increased while receipt of surgical-type procedures decreased. These findings emphasize the health-promoting role of the dental team and provide a baseline for the measurement of future trends.
在美国,医疗保健成本不断增加,而州和联邦预算却在缩减。为了建立一个基线并为替代性口腔卫生人力模式提供数据,本报告描述了2009年美国劳动年龄成年人接受的牙科程序类型,并审视了自1999年以来的趋势。
本分析的数据来自1999年和2009年的医疗支出小组调查。主要结果变量代表前一年牙科就诊期间接受的牙科程序类型。描述性变量包括牙科保险覆盖范围和收入。分析仅限于21至64岁的成年人。
2009年,诊断和预防性程序占劳动年龄成年人接受的所有牙科服务的75%以上。与同龄人相比,拥有公共保险的人、未参保的人以及低收入者接受这些服务的可能性较小。1999年至2009年期间,全国接受预防性和诊断性程序的比例有小幅但具有统计学意义的增加。在此期间,就诊时接受预防性服务的可能性也有所增加,而接受修复性程序的概率则下降。
预防性程序占2009年劳动年龄成年人接受的牙科服务的绝大部分。1999年至2009年期间,预防性程序的接受率总体上升,而手术性程序的接受率下降。这些发现强调了牙科团队在促进健康方面的作用,并为衡量未来趋势提供了一个基线。