Gilbert Gregg H, Gordan Valeria V, Korelitz James J, Fellows Jeffrey L, Meyerowitz Cyril, Oates Thomas W, Rindal D Brad, Gregory Randall J
Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, SDB Room 109, 1530 Third Avenue South, Birmingham, AL 35294-0007, USA.
BMC Oral Health. 2015 Jan 22;15:11. doi: 10.1186/1472-6831-15-11.
Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics.
GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics.
Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients.
As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.
目标如下:(1)确定普通牙医(GDs)是否以及多久进行一次特定的牙科手术;(2)检验以下假设,即手术实施与关键的牙医、诊所及患者特征相关。
美国国家基于牙科实践的研究网络中的普通牙医(n = 2367)完成了一份注册调查问卷,其中包括:(1)牙医;(2)诊所;(3)患者特征,以及他们进行10种牙科手术的频率。我们确定了手术的实施频率,并检验了手术实施与这三组特征存在实质性关联的假设。
两类手术被归类为“不常见”(正畸、牙周手术),三类为“常见”(磨牙牙髓病治疗;种植牙;非手术牙周治疗),五类为“非常常见”(修复;美容手术;拔牙;可摘义齿修复;非磨牙牙髓病治疗)。牙医、诊所和患者特征与手术实施存在实质性关联;一些特征似乎具有普遍影响,如牙医性别、毕业后培训、全职/兼职状态、私人诊所与机构诊所、同一诊所是否有专科医生以及患者的保险状况。
总体而言,普通牙医提供广泛的手术种类。然而,个体牙医的手术实施与某些牙医、诊所和患者特征存在实质性关联。大量且广泛的因素似乎影响着普通牙医实施哪些手术。这可能对普通牙医如何应对不断变化的牙科护理利用情况、患者人口统计学、执业范围、服务提供模式以及普通牙医在初级保健中不断演变的角色产生影响。