Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA.
Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, NY, USA.
Community Dent Oral Epidemiol. 2018 Feb;46(1):102-108. doi: 10.1111/cdoe.12334. Epub 2017 Oct 11.
The identification of persons with or at risk for chronic diseases is a new practice paradigm for oral healthcare. Diabetes mellitus (DM) is a chronic disease of particular importance to oral health providers. This study sought to understand healthcare utilization patterns that would support the introduction of this new practice paradigm.
The primary and oral healthcare utilization patterns of New York City (NYC) adults were assessed using data collected from the 2013 NYC Community Health Survey. We stratified healthcare utilization patterns by type of provider, insurance, DM diagnosis and DM modifiable risk factors.
Of 6.4 million NYC adults, an estimated 676 000 (10.5%) reported a previous diagnosis of DM, and 3.9 million (69.5%) were identified with one or more modifiable risk factor for DM. Of these at risk individuals, 2.2 million (58.9%) received dental services in the past 12 months, and 545 000 (14.3%) did not see a primary care provider during the same period. Of the approximately 1.16 million adults without health insurance, an estimated 338 000 (26.2%) had a dental visit only.
Healthcare utilization patterns in this urban setting suggest that oral healthcare providers can support the identification of patients with and at risk for DM who may otherwise not have the opportunity for screening.
慢性病患者或有慢性病风险人群的识别是口腔保健的一种新的实践模式。糖尿病(DM)是口腔健康提供者特别关注的一种慢性疾病。本研究旨在了解支持引入这一新实践模式的医疗保健利用模式。
利用 2013 年纽约市社区健康调查收集的数据,评估了纽约市成年人的初级保健和口腔保健利用模式。我们按提供者类型、保险、DM 诊断和 DM 可改变的风险因素对医疗保健利用模式进行了分层。
在 640 万纽约市成年人中,估计有 67.6 万人(10.5%)报告了以前的 DM 诊断,390 万人(69.5%)有一个或多个 DM 的可改变风险因素。在这些有风险的人群中,220 万人(58.9%)在过去 12 个月内接受了牙科服务,而同期有 54.5 万人(14.3%)没有看初级保健医生。在大约 116 万没有健康保险的成年人中,估计有 33.8 万人(26.2%)仅进行了牙科就诊。
在这种城市环境中,医疗保健利用模式表明口腔保健提供者可以支持识别可能没有机会接受筛查的 DM 患者和有风险的患者。