Huang Ren-Yeong, Lin Yuh-Feng, Kao Sen-Yeong, Shieh Yi-Shing, Chen Jin-Shuen
Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan ; Division of Nephrology, Department of Medicine, Shuang Ho Hospital, New Taipei City, Taiwan ; Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan.
PLoS One. 2014 Feb 12;9(2):e88418. doi: 10.1371/journal.pone.0088418. eCollection 2014.
To determine if expenditures for dentistry (DENT) correlate with severity of chronic kidney disease (CKD).
A total of 10,457 subjects were enrolled from January 2008 to December 2010, divided into three groups: healthy control (HC) group (n = 1,438), high risk (HR) group (n = 3,392), and CKD group (n = 5,627). Five stages were further categorized for the CKD group. OPD utilization and expenditures for western medicine (WM), DENT, and TCM (traditional Chinese medicine) were analyzed retrospectively (2000-2008) using Taiwan's National Health Insurance Research Database. Three major areas were analyzed among groups CKD, HR and HC in this study: 1) demographic data and medical history; 2) utilization (visits/person/year) and expenditures (9-year cumulative expenditure, expenditure/person/year) for OPD services in WM, DENT, and TCM; and 3) utilization and expenditures for dental OPD services, particularly in dental filling, root canal and periodontal therapy.
OPD utilization and expenditures of WM increased significantly for the CKD group compared with the HR and HC groups, and increased steadily along with the severity of CKD stages. However, overall DENT and TCM utilization and expenditures did not increase for the CKD group. In comparison among different CKD stages, the average expenditures and utilization for DENT including restorative filling and periodontal therapy, but not root canal therapy, showed significant decreases according to severity of CKD stage, indicating less DENT OPD utilization with progression of CKD.
Patients with advanced CKD used DENT OPD service less frequently. However, the connection between CKD and DENT service utilization requires further study.
确定牙科支出（DENT）是否与慢性肾脏病（CKD）的严重程度相关。
2008年1月至2010年12月共纳入10457名受试者，分为三组：健康对照组（HC组，n = 1438）、高危组（HR组，n = 3392）和CKD组（n = 5627）。CKD组进一步分为五个阶段。利用台湾地区全民健康保险研究数据库对2000 - 2008年的门诊利用情况以及西药（WM）、牙科（DENT）和中药（TCM）的支出进行回顾性分析。本研究在CKD组、HR组和HC组中分析了三个主要方面：1）人口统计学数据和病史；2）西药、牙科和中药门诊服务的利用情况（就诊次数/人/年）和支出（9年累计支出、支出/人/年）；3）牙科门诊服务的利用情况和支出，特别是补牙、根管治疗和牙周治疗方面。
与HR组和HC组相比，CKD组西药门诊利用和支出显著增加，且随CKD阶段严重程度稳步上升。然而，CKD组牙科和中药的总体利用和支出并未增加。在不同CKD阶段之间比较，包括补牙和牙周治疗但不包括根管治疗的牙科平均支出和利用情况，根据CKD阶段严重程度显示出显著下降，表明随着CKD进展，牙科门诊利用减少。
晚期CKD患者较少使用牙科门诊服务。然而，CKD与牙科服务利用之间的联系需要进一步研究。
