Chebib Najla, Abou-Ayash Samir, Maniewicz Sabrina, Srinivasan Murali, Hill Harry, McKenna Gerald, Holmes Emily, Schimmel Martin, Brocklehurst Paul, Müller Frauke
Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
Swiss Dent J. 2020 Nov 3;130(11):876-884. doi: 10.61872/sdj-2020-11-690. Print 2020 Nov 9.
The objective of this study was to explore the preferred dental services of older people for when they become dependent. It aimed to assess their preferred type of health care professional and location of dental service, and relate their preferences to their willingness to pay (WTP) and willingness to travel (WTT). Older people aged 65 years or older were invited to participate in a questionnaire-based discrete choice experiment (DCE), to measure preferences for dental examinations and treatment, defined by two attributes: type of professional and location of the activity. Hypothetical scenarios based attributes were displayed in a projected visual presentation and participants noted their personal preference using a response sheet. Data was analyzed using a random-effects logit model. Eighty-nine participants (mean age 73.7 ± 6.6 years) attended focus group sessions. Respondents preferred that the family dentist (β: 0.2596) or an auxiliary (β: 0.2098) undertake the examination and wanted to avoid a medical doctor (β: –0.469). The preferred location for dental examination was at a dental practice (β: 0.2204). Respondents preferred to avoid treatments at home (β: –0.3875); they had a significant preference for treatment at the dental office (β: 0.2255) or in a specialist setting (β: 0.1620, ns). However, the type of professional did not have a significant influence on overall preference. Participants with a low WTP preferred examination at home (β: 0.2151) and wanted to avoid the dental practice (β: –0.0235), whereas those with a high WTP preferred the dental office (β: 0.4535) rather than home (β: –0.3029). WTT did not have a significant influence on preference. The study showed that older people generally preferred receiving dental services in a dental practice or specialist setting, and would prefer not to be treated at home. Continuity of dental services provided by the family dentist should therefore be prioritized where possible and further studies should examine the role of domiciliary care at home.
本研究的目的是探讨老年人在生活不能自理时对牙科服务的偏好。研究旨在评估他们对医疗保健专业人员的偏好类型和牙科服务地点，并将他们的偏好与其支付意愿（WTP）和出行意愿（WTT）联系起来。邀请65岁及以上的老年人参与基于问卷的离散选择实验（DCE），以测量对牙科检查和治疗的偏好，该偏好由两个属性定义：专业人员类型和活动地点。基于属性的假设情景以投影视觉展示呈现，参与者使用答卷记录他们的个人偏好。使用随机效应logit模型分析数据。89名参与者（平均年龄73.7±6.6岁）参加了焦点小组会议。受访者更倾向于由家庭牙医（β：0.2596）或辅助人员（β：0.2098）进行检查，并希望避免由医生进行检查（β：–0.469）。牙科检查的首选地点是牙科诊所（β：0.2204）。受访者倾向于避免在家中接受治疗（β：–0.3875）；他们对在牙科诊所（β：0.2255）或专科机构接受治疗有明显偏好（β：0.1620，无显著差异）。然而，专业人员类型对总体偏好没有显著影响。支付意愿低的参与者更喜欢在家中接受检查（β：0.2151），并希望避免去牙科诊所（β：–0.0235），而支付意愿高的参与者更喜欢牙科诊所（β：0.4535）而不是家中（β：–0.3029）。出行意愿对偏好没有显著影响。研究表明，老年人通常更喜欢在牙科诊所或专科机构接受牙科服务，并且不愿意在家中接受治疗。因此，应尽可能优先考虑家庭牙医提供的牙科服务的连续性，并且进一步的研究应考察居家护理的作用。
