McKenzie K W, Goodwin M, Pretty I
The University of Manchester, Dental Health Unit, Williams House, Manchester Science Park, Lloyd Street North, Manchester, Greater Manchester M15 6SE.
Br Dent J. 2017 Jul 21;223(2):102-107. doi: 10.1038/sj.bdj.2017.624.
Objective To explore NHS dental service utilisation (attendance and treatment activity) of older adults.Design Retrospective analysis of dental treatment claim forms (FP17s) over a 15 month period.Population A total of 690,433 older adults in North West England.Results NHS dental care attendance decreased with increasing age; 49% in 65-74 years, 39% in 75-84 years and 23% in the over 85 years age group. Across all older age stratifications, the more deprived patients had a higher rate of examinations, extractions, dentures and preventative advice compared to the least deprived patients. However, the relationship was opposite for the rate of fillings and complex restorative treatment; the rate was higher for the least deprived older adult patients.Conclusions Despite 95% of older adults living in the community, the number of older adults accessing NHS dental care in this data set is thought-provoking. Additionally, there is a complex relationship between the type of treatment provided and the patient's IMD level. The authors acknowledge the major limitations of this dataset; affluent people are more likely to access private dental care and the availability of NHS dental services is likely to vary across different regions. However, the use of 'big data' is necessary to provide a pragmatic approach for future research in the management of older adults in general dental services.
目的 探讨老年人对国民保健署(NHS)牙科服务的利用情况(就诊率和治疗活动)。
设计 对15个月期间的牙科治疗索赔表(FP17s)进行回顾性分析。
研究对象 英格兰西北部的690433名老年人。
结果 国民保健署牙科护理就诊率随年龄增长而下降;65 - 74岁年龄段为49%,75 - 84岁年龄段为39%,85岁以上年龄段为23%。在所有老年分层中,与最不贫困的患者相比,贫困程度较高的患者接受检查、拔牙、假牙修复和预防性建议的比例更高。然而,补牙和复杂修复治疗的比例情况则相反;最不贫困的老年患者比例更高。
结论 尽管95%的老年人生活在社区,但该数据集中使用国民保健署牙科护理的老年人数量发人深省。此外,所提供的治疗类型与患者的多重贫困指数(IMD)水平之间存在复杂关系。作者承认该数据集存在重大局限性;富裕人群更有可能获得私人牙科护理,而且国民保健署牙科服务的可及性在不同地区可能有所不同。然而,利用“大数据”对于为一般牙科服务中老年人管理的未来研究提供务实方法是必要的。