Kateeb Elham Talib, Warren John, Gaeth Gary, Damiano Peter, Momany Elizabeth, Kanellis Michael J, Weber-Gasparoni Karin, Ansley Timothy
Oral Health Research and Promotion, Al Quds University, Jerusalem, Palestine; Public Policy Center, University of Iowa, Iowa City, IA, USA.
J Public Health Dent. 2014 Summer;74(3):234-40. doi: 10.1111/jphd.12052. Epub 2014 Mar 17.
The atraumatic restorative treatment (ART) was developed as an affordable, patient-friendly dental caries management procedure that does not need extensive operator training or special skills. The aim of this study was to determine factors that influence the decision to use ART using an innovative marketing research technique known as conjoint analysis.
A conjoint survey was completed by 723 members of the American Academy of Pediatric Dentistry. Three factors (age of the child, level of cooperation, type of insurance) were varied across three levels to create nine patient scenarios. The weights that practitioners placed on these factors in decisions to use ART in treating carious lesions were determined by conjoint analysis. Factors such as lesion location, depth, and extension were fixed in the nine clinical scenarios.
Seven-hundred twenty-three pediatric dentists completed the survey (32 percent). Age of the child was the most important factor in pediatric dentists' decisions to use ART (46 percent) compared with level of cooperation (41 percent) and type of insurance coverage (11 percent). For the age factor, the age of 2 years had the greatest utility (0.55) compared with age 4 (-0.09) and age 6 (-0.46). For types of insurance coverage, having no insurance (0.124) had the greatest utility compared with having public insurance (-0.119).
Although insurance coverage was the least important among the factors, being without insurance, being very young, and being uncooperative was the scenario where pediatric dentists most favored ART when making trade offs between different factors using the conjoint design.
非创伤性修复治疗(ART)是一种经济实惠、对患者友好的龋齿管理方法,无需操作人员接受广泛培训或具备特殊技能。本研究旨在使用一种名为联合分析的创新市场研究技术,确定影响使用ART决策的因素。
美国儿科学会的723名成员完成了一项联合调查。三个因素(儿童年龄、合作程度、保险类型)在三个水平上变化,以创建九个患者场景。通过联合分析确定从业者在决定使用ART治疗龋损时对这些因素的重视程度。在九个临床场景中,病变位置、深度和范围等因素是固定的。
723名儿科牙医完成了调查(32%)。与合作程度(41%)和保险覆盖类型(11%)相比,儿童年龄是儿科牙医决定使用ART的最重要因素(46%)。对于年龄因素,2岁的效用最大(0.55),而4岁(-0.09)和6岁(-0.46)的效用较小。对于保险覆盖类型,没有保险(0.124)的效用最大,而有公共保险(-0.119)的效用较小。
尽管保险覆盖在这些因素中是最不重要的,但在使用联合设计在不同因素之间进行权衡时,没有保险、年龄非常小且不合作的情况是儿科牙医最倾向于使用ART的场景。