服务不足妇女的围产期口腔健康：北卡罗来纳州患者、提供者和政策制定者的行动呼吁。
Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers.
机构信息
Regional Public Health Dentist, Oral Health Section, Division of Public Health, North Carolina Department of Health and Human Services, 1910 Mail Service, Raleigh, NC, 27699-1910, USA.
Pediatric Dentistry and Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Matern Child Health J. 2020 Mar;24(3):351-359. doi: 10.1007/s10995-019-02868-4.
INTRODUCTION
Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services.
METHODS
A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014-2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data.
RESULTS
Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service-less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015.
DISCUSSION
Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels.
简介
在提供者和孕妇中，关于口腔保健在妊娠前后的重要性和安全性的知识差距依然存在。本文描述了北卡罗来纳州（NC）服务不足的孕妇的围产期口腔健康和保健的现状，并提供了改善其获得和利用牙科服务的政策建议。
方法
使用（a）2016 年在 NC 进行的 459 名孕妇的便利样本的口腔健康监测数据，（b）2014-2016 年 Medicaid 牙科提供者和 Medicaid 为孕妇（MPW）计划的牙科服务利用率数据，以及（c）2017 年 Medicaid 牙科福利政策进行描述性分析。监测数据与 Medicaid 牙科服务利用率数据未关联。
结果
接受调查的孕妇中，不到 20%的人报告在怀孕期间进行过牙科就诊，口腔筛查显示 33%的人患有未经治疗的龋齿。自 2014 年以来， Medicaid 数据显示，利用任何牙科服务的 MPW 受益人的百分比稳步下降，截至 2016 年，这一比例不足 10%。由于在 NC 政策中，牙科护理不被视为与妊娠相关，因此 MPW 分娩时牙科福利会失效。2015 年，只有 20%的 NC 执业牙医为 MPW 受益人提供护理。
讨论
孕妇、医疗保健专业人员和政策制定者在口腔健康知识、信念和实践方面存在不足。需要全州范围内的努力来促进围产期护理的标准，该标准强调协作实践，并解决患者、提供者和政策层面上存在的现有障碍。
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