Brondani Mario A, Wallace Bruce, Donnelly Leeann R
J Can Dent Assoc. 2019 Oct;85:j10.
To examine patient demographics, distance traveled and dental-related treatment provided according to type of dental insurance at a large, not-for-profit community dental clinic (CDC) in Vancouver, Canada.
Using electronic dental records, we assessed the use of private and government-sponsored (public) dental insurance at the CDC in 2014 and 2015 at the appointment and procedure levels. Study variables included patient demographics, distance traveled, type of treatment provided, type of dental insurance and cost of treatment.
Examination of records from 9524 appointments involving 16 639 procedures revealed that 44% (4190 appointments) were made by patients with private insurance and 31.4% (2995) by those with public insurance. Patients with private dental insurance were 1.27 times more likely (p < 0.001) to have restorative treatment than those with public-sponsored dental insurance. Procedures involving tooth extraction were 14.2 times more likely (p < 0.001) to be performed in patients with public insurance than those with private insurance.
Access does not equal equity; although the CDC enables access by various populations, its ability to provide equitable treatment is compromised by external factors. CDCs may have a vital role in oral health equity; however, dental treatment continues to be dictated by financial reimbursement.
在加拿大温哥华一家大型非营利性社区牙科诊所（CDC），根据牙科保险类型，研究患者人口统计学特征、就诊距离以及提供的牙科相关治疗。
利用电子牙科记录，我们在预约和治疗程序层面评估了2014年和2015年该社区牙科诊所私人和政府资助（公共）牙科保险的使用情况。研究变量包括患者人口统计学特征、就诊距离、提供的治疗类型、牙科保险类型以及治疗费用。
对涉及16639项治疗程序的9524次预约记录的检查显示，44%（4190次预约）是由拥有私人保险的患者进行的，31.4%（2995次）是由拥有公共保险的患者进行的。拥有私人牙科保险的患者接受修复治疗的可能性是拥有政府资助牙科保险患者的1.27倍（p<0.001）。涉及拔牙的治疗程序在拥有公共保险的患者中进行的可能性是拥有私人保险患者的14.2倍（p<0.001）。
可及性并不等同于公平性；尽管社区牙科诊所使不同人群都能获得治疗，但其提供公平治疗的能力受到外部因素的影响。社区牙科诊所在口腔健康公平方面可能发挥重要作用；然而，牙科治疗仍然受财务报销的支配。
