Woods N, Ahern S, Burke F, Eaton K A, Widström E
College of Business and Law, University College Cork; Researcher Oral Health Services Research Centre, College of Medicine &Health, University College Cork; Cork, Ireland.
Oral Health Services Research Centre, College of Medicine &Health, University College Cork, Cork, Ireland.
Br Dent J. 2017 Apr 7;222(7):541-548. doi: 10.1038/sj.bdj.2017.317.
The Irish oral healthcare system is a hybrid model with a public/private mix of service provision, predominantly organised on the basis of fee-per-item remuneration. The system is structured around three long standing publicly funded schemes: the Public Dental Service (PDS) for all children and adults with special needs and provided by salaried dentists, the Dental Treatment Services Scheme (DTSS) for low income adults, and the Dental Treatment Benefit Scheme (DTBS) for insured persons, the latter two both provided by private independent dental practitioners. Ireland introduced systemic water fluoridation in 1963 and currently 73% of the population has access to fluoridated water. Ireland currently has a dentist density ratio of 6.1 dentists per 10,000 inhabitants and on average, 43% of the population (30% for those aged 70+ years) visit a dentist annually. In 2014, 83% of expenditure on oral healthcare was from out-of-pocket payments by patients, with less than 1% of overall government expenditure on healthcare allotted to oral healthcare. After the economic downturn of 2008 and the severe recession that followed in Ireland, substantial cutbacks in government expenditure resulted in extensive cuts to the public sector supply of dental services and to the extent of cover provided by the publicly funded schemes. The Department of Health has recognised the major post recessionary challenges facing the Irish health system, not least, significantly reduced budgets and capacity deficits, and acknowledges the need for change in Ireland's health service. In 2014, a three-year project commenced at the Department of Health, to develop a new national oral health policy for Ireland.
爱尔兰口腔医疗保健系统是一种公私混合的服务提供模式，主要基于按项目收费的薪酬方式组织。该系统围绕三个长期的公共资助计划构建：为所有儿童和有特殊需求的成年人提供的公共牙科服务（PDS），由受薪牙医提供；为低收入成年人提供的牙科治疗服务计划（DTSS）；为被保险人提供的牙科治疗福利计划（DTBS），后两者均由私立独立牙科从业者提供。爱尔兰于1963年引入系统性水氟化措施，目前73%的人口能够使用含氟水。爱尔兰目前的牙医密度为每10000名居民中有6.1名牙医，平均而言，43%的人口（70岁及以上人群为30%）每年看一次牙医。2014年，口腔医疗保健支出的83%来自患者自掏腰包支付，政府医疗保健总支出中分配给口腔医疗保健的不到1%。在2008年爱尔兰经济衰退及随后的严重衰退之后，政府大幅削减开支，导致公共部门牙科服务供应大幅减少，公共资助计划提供的覆盖范围也大幅缩减。卫生部认识到爱尔兰医疗系统在衰退后面临的重大挑战，尤其是预算大幅减少和能力不足，并承认爱尔兰医疗服务需要变革。2014年，卫生部启动了一个为期三年的项目，为爱尔兰制定一项新的国家口腔健康政策。
