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学校牙科筛查的资源再分配模型:利用远程牙科在低风险地区的优势。

A resource reallocation model for school dental screening: taking advantage of teledentistry in low-risk areas.

机构信息

International Research Collaborative-Oral Health and Equity: School of Human Science, University of Western Australia, Crawley, WA, Australia.

Department of Anatomy and Human Biology, School of Human Science, University of Western Australia, Crawley, WA, Australia.

出版信息

Int Dent J. 2018 Aug;68(4):262-268. doi: 10.1111/idj.12379. Epub 2018 Jan 30.

Abstract

OBJECTIVE

To estimate the scale of resource transfer that could be achieved by screening low-risk schoolchildren using teledentistry rather than using traditional visual dental examination.

METHODS

This study was based on a previous cost-minimisation study that compared the costs of two dental-screening approaches (visual and teledentistry). The data for the population of children 5-14 years of age was obtained from the Australian Bureau of Statistics and was divided across Australia according to statistical local area (SA2). The cost models (for teledentistry and visual screening) for each SA2 relative to the state, Remoteness Area (RA) and Socio-Economic Index for Area (SEIFA) indexes were estimated. The geographical information system was used to superimpose modelled cost data on the geographical map to provide a visual presentation of the data. Resource transfer scenarios, based on risk minimisation, were then developed and analysed.

RESULTS

This study demonstrated a suboptimal allocation of dental-care resources, such that children living in high socio-economic areas (major cities) with low disease burdens consuming half of the estimated resources of a universal visual dental screening system. The findings suggest that utilising teledentistry screening for low-risk children has the potential to free up $40 million per annum. Such resources can be reallocated to increase care access and improve the quality of dental services for vulnerable children.

CONCLUSION

To reduce inequalities in dental health within a community, scarce health-care resources should be targeted at the population at most risk. These findings can be used to inform policymakers, guide the appropriate distribution of scarce resources and target dental services to benefit high-need children.

摘要

目的

通过远程牙科检查而非传统的目视牙科检查来估算对低危学龄儿童进行筛查可实现的资源转移规模。

方法

本研究基于一项先前的成本最小化研究,该研究比较了两种牙科筛查方法(目视和远程牙科)的成本。5-14 岁儿童的数据来自澳大利亚统计局,并根据统计地方区域(SA2)在澳大利亚进行划分。针对每个 SA2,相对于州、偏远地区(RA)和社会经济区域指数(SEIFA)指数,估算了远程牙科和目视筛查的成本模型。使用地理信息系统将模型化的成本数据叠加在地理地图上,以直观展示数据。然后,基于风险最小化制定和分析了资源转移方案。

结果

本研究表明,牙科保健资源的分配存在不合理之处,居住在高社会经济地区(主要城市)且疾病负担较低的儿童消耗了通用目视牙科筛查系统估计资源的一半。研究结果表明,利用远程牙科筛查对低危儿童进行筛查,每年可节省 4000 万美元。这些资源可以重新分配,以增加弱势儿童的护理机会并提高牙科服务质量。

结论

为了减少社区内牙科健康方面的不平等,应将稀缺的医疗保健资源瞄准风险最高的人群。这些发现可用于为决策者提供信息,指导稀缺资源的合理分配,并将牙科服务重点用于受益于高需求儿童。

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