Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany.
Institute of German Dentists (IDZ), Cologne.
JDR Clin Trans Res. 2020 Oct;5(4):349-357. doi: 10.1177/2380084420904928. Epub 2020 Feb 5.
We aimed to predict the usage of dental services in Germany from 2000 to 2015 based on epidemiologic and demographic data, and to compare these predictions against claims within the statutory health insurance.
Indicators for operative (number of coronally decayed or filled teeth, root surface caries lesions, and fillings), prosthetic (number of missing teeth), and periodontal treatment needs (number of teeth with probing pocket depths (PPDs) ≥ 4 mm) from nationally representative German Oral Health Studies (1997, 2005, 2014) were cross-sectionally interpolated across age and time, and combined with year- and age-specific population estimates. These, as well as the number of children eligible for individual preventive services (aged 6 to 17 y), were adjusted for age- and time-specific insurance status and services' utilization to yield predicted usage of operative, prosthetic, periodontal, and preventive services. Cumulative annual usage in these 4 services groups were compared against aggregations of a total of 24 claims positions from the statutory German health insurance.
Morbidity, utilization, and demography were highly dynamic across age groups and over time. Despite improvements of individual oral health, predicted usage of dental services did not decrease over time, but increased mainly due to usage shifts from younger (shrinking) to older (growing) age groups. Predicted usage of operative services increased between 2000 and 2015 (from 52 million to 56 million, +7.8%); predictions largely agreed with claimed services (root mean square error [RMSE] 1.9 million services, error range -4.6/+3.8%). Prosthetic services increased (from 2.4 million to 2.6 million, +11.9%), with near perfect agreement to claimed data [RMSE 0.1 million services, error range -8.3/+3.9%]). Periodontal services also increased (from 21 million to 27 million, +25.9%; RMSE 5.2 million services, error range +21.9/+36.5%), as did preventive services (from 22 million to 27 million, +20.4%; RMSE 3 million, error range -13.7/-4.7%).
Predicting dental services seems viable when accounting for the joint dynamics of morbidity, utilization, and demographics.
Based on epidemiologic and demographic data, predicting usage of certain dental services is viable when accounting for the dynamics of morbidity, utilization, and demographics.
基于流行病学和人口统计学数据，预测 2000 年至 2015 年德国牙科服务的使用情况，并将这些预测与法定健康保险范围内的索赔进行比较。
从具有代表性的德国口腔健康研究（1997 年、2005 年和 2014 年）中，交叉插补各年龄组和时间的手术（冠龋或填充的牙齿数量、根面龋损、和填充物）、修复（缺失牙齿数量）和牙周治疗需求（探诊袋深度（PPD）≥4 毫米的牙齿数量）的指标，结合逐年和年龄特定的人口估计数。这些以及有资格接受个体预防服务的儿童人数（6 至 17 岁），根据年龄和时间特定的保险状况和服务利用率进行调整，以得出手术、修复、牙周和预防服务的预测使用情况。将这 4 个服务组的累积年度使用率与法定德国健康保险的 24 个索赔位置的总和进行比较。
发病率、利用率和人口统计学在年龄组和时间上都非常动态。尽管个人口腔健康状况有所改善，但牙科服务的使用量并未随着时间的推移而减少，而是主要由于使用从年轻（收缩）到老年（增长）年龄组的转变而增加。手术服务的使用量从 2000 年到 2015 年增加（从 5200 万增加到 5600 万，增加了 7.8%）；预测结果与索赔服务基本一致（均方根误差[RMSE]为 190 万服务，误差范围为-4.6/+3.8%）。修复服务增加（从 240 万增加到 260 万，增加了 11.9%），与索赔数据几乎完全一致[RMSE 为 10 万服务，误差范围为-8.3/+3.9%]）。牙周服务也增加（从 2100 万增加到 2700 万，增加了 25.9%；RMSE 为 520 万服务，误差范围为+21.9/+36.5%），预防服务也增加（从 2200 万增加到 2700 万，增加了 20.4%；RMSE 为 300 万，误差范围为-13.7/-4.7%）。
当考虑发病率、利用率和人口统计学的综合动态时，预测牙科服务似乎是可行的。
当考虑发病率、利用率和人口统计学的动态时，基于流行病学和人口统计学数据，预测某些牙科服务的使用情况是可行的。
