Rosenberg D J, Koch A L, Cretin S, Schoen M H, Marcus M
J Dent Educ. 1986 Nov;50(11):665-72.
Increased time to treat the special patient is often cited as a barrier to dental care. The purpose of this study was to analyze the separate and combined effects of differences in dental services planned, services actually performed, and differences in treatment time requirements between special and nonspecial patients in a hospital ambulatory clinical setting. Data for this study were obtained from the UCLA evaluators of the RWJ-funded Hospital-Sponsored Ambulatory Dental Services Program (HSADSP). The results show that special patients require more dental treatment than nonspecial patients for advanced dental disease (i.e., periodontics, surgery, and removable prosthetics) and that they receive more of such services. The study also found that special patients should not be viewed as a homogeneous group when evaluating dental needs and required time resources for treatment. Three subgroups of special patients were identified: developmentally disabled, severely compromised, and moderately compromised. The developmentally disabled as compared to the nonspecial patients required significantly more (20 percent) provider time in completing a "representative" treatment plan.
治疗特殊患者所需时间增加常常被视为牙科护理的障碍。本研究的目的是分析在医院门诊临床环境中，计划的牙科服务差异、实际提供的服务以及特殊患者与非特殊患者在治疗时间需求上的差异所产生的单独和综合影响。本研究的数据来自于由罗伯特·伍德·约翰逊基金会资助的医院赞助门诊牙科服务项目（HSADSP）的加州大学洛杉矶分校评估人员。结果表明，对于晚期牙科疾病（即牙周病、外科手术和可摘义齿修复），特殊患者比非特殊患者需要更多的牙科治疗，并且他们接受了更多此类服务。该研究还发现，在评估牙科需求和治疗所需的时间资源时，不应将特殊患者视为一个同质化群体。已确定特殊患者的三个亚组：发育障碍者、严重功能受损者和中度功能受损者。与非特殊患者相比，发育障碍者在完成一个“代表性”治疗计划时需要显著更多（20%）的医生时间。
