Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA.
Departments of Health Services Research and Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Public Health Dent. 2017 Sep;77(4):383-392. doi: 10.1111/jphd.12230. Epub 2017 Jul 7.
Rural residents are overrepresented in the military; however, access to Veteran services is limited in rural areas. There is a need to identify rural Veteran healthcare utilization. This study addresses that need and has two purposes: a) to determine if there is an association between rural dwelling and Veteran utilization of dental services; and b) to determine if there is an association between rural dwelling and the oral health outcome of missing teeth.
Data from the 2014 Behavioral Risk Factor Surveillance Survey were used in this study. Chi square and logistic regression analyses were conducted.
Rural Veterans were less likely to have a dental visit during the previous year as compared with metropolitan Veterans in unadjusted analysis (Odds ratio = 0.71, 95% Confidence Interval, 0.64, 0.77) and in adjusted analysis [0.87 (95% Confidence Interval, 0.78, 0.96)]. In cases in which all teeth were missing, rural Veterans had an unadjusted odds ratio of 1.79 [95% Confidence Interval, 1.55, 2.08] and an adjusted odds ratio of 1.37 [95% Confidence Interval, 1.17, 1.62] as compared with metropolitan Veterans.
The Veterans Health Administration develops policies for establishing centers for care for Veterans. The policy development should take into consideration that rural Veterans have not been as likely as urban Veterans to utilize dental services and have poorer oral health outcomes.
农村居民在军队中所占比例过高；然而，农村地区获得退伍军人服务的机会有限。有必要确定农村退伍军人的医疗保健利用情况。本研究满足了这一需求，具有两个目的：a）确定农村居住与退伍军人牙科服务利用之间是否存在关联；b）确定农村居住与缺牙的口腔健康结果之间是否存在关联。
本研究使用了 2014 年行为风险因素监测调查的数据。进行了卡方检验和逻辑回归分析。
与大都市退伍军人相比，未经调整分析（优势比=0.71，95%置信区间，0.64，0.77）和调整分析[0.87（95%置信区间，0.78，0.96）]，农村退伍军人在过去一年中进行牙科就诊的可能性较小。在所有牙齿缺失的情况下，农村退伍军人的未调整优势比为 1.79 [95%置信区间，1.55，2.08]，调整优势比为 1.37 [95%置信区间，1.17，1.62]与大都市退伍军人相比。
退伍军人健康管理局制定了为退伍军人设立护理中心的政策。政策制定应考虑到农村退伍军人不太可能像城市退伍军人那样利用牙科服务，并且口腔健康状况较差。
