Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.
Melbourne Dental School, Melbourne University, Melbourne, Vic., Australia.
Int Dent J. 2018 Aug;68(4):235-244. doi: 10.1111/idj.12382. Epub 2018 Feb 21.
Understanding dental therapy practice across clinical settings is useful for education and service planning. This study assessed if dental therapy service provision varied according to practitioner and workplace characteristics.
Members of professional associations representing dental therapists (DT) and oral health therapists (OHT) were posted a self-complete survey collecting practitioner and workplace characteristics, together with clinical activity on a self-selected typical day of practice. Differences in service provision according to characteristics were assessed by comparing mean services per patient visit. Negative binomial regression models estimated adjusted ratios (R) of mean services per patient.
The response rate was 60.6%. Of practitioners registered as an OHT or a DT, 80.0% (n = 500) were employed in general clinical practice. Nearly one-third of OHT and nearly two-thirds of DT worked in public sector dental services. Patterns of service provision varied significantly according to practice sector and other characteristics. After adjusting for characteristics, relative to private sector, public sector practitioners had higher provision rates of fissure sealants (R = 3.79, 95% confidence interval [95% CI]: 2.84-5.06), restorations (R = 3.78, 95% CI: 2.94-4.86) and deciduous tooth extractions (R = 3.58, 95% CI: 2.60-4.93) per patient visit, and lower provision rates of oral health instruction (R = 0.86, 95% CI: 0.76-0.98), fluoride applications (R = 0.43, 95% CI: 0.33-0.56), scale and cleans (R = 0.39, 95% CI: 0.34-0.45) and periodontal services (R = 0.20, 95% CI: 0.14-0.28) per patient visit.
Differences in service provision according to sector indicate that OHT and DT adapt to differing patient groups and models of care. Variations may also indicate that barriers to utilising the full scope of practice exist in some settings.
了解临床环境中的牙科治疗实践情况有助于教育和服务规划。本研究评估了牙科治疗服务的提供是否因从业者和工作场所的特征而有所不同。
专业协会的牙科治疗师(DT)和口腔健康治疗师(OHT)成员收到了一份自我完成的调查,该调查收集了从业者和工作场所的特征,以及在自我选择的典型实践日的临床活动。通过比较每位患者就诊的平均服务量,评估了服务提供情况根据特征的差异。使用负二项回归模型估计了每位患者平均服务量的调整比值(R)。
回应率为 60.6%。在注册为 OHT 或 DT 的从业者中,80.0%(n = 500)在普通临床实践中工作。近三分之一的 OHT 和近三分之二的 DT 在公共部门牙科服务中工作。服务提供模式根据实践部门和其他特征有显著差异。在调整特征后,与私营部门相比,公共部门从业者的窝沟封闭剂(R = 3.79,95%置信区间[95%CI]:2.84-5.06)、修复体(R = 3.78,95%CI:2.94-4.86)和乳牙拔除术(R = 3.58,95%CI:2.60-4.93)的提供率更高,口腔健康指导(R = 0.86,95%CI:0.76-0.98)、氟化物应用(R = 0.43,95%CI:0.33-0.56)、洁治(R = 0.39,95%CI:0.34-0.45)和牙周服务(R = 0.20,95%CI:0.14-0.28)的提供率更低。
根据部门提供服务的差异表明,OHT 和 DT 根据不同的患者群体和护理模式进行调整。差异也可能表明在某些环境中存在利用实践全部范围的障碍。