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基层医疗中口腔急诊治疗的风险评估:一项横断面研究。

Risk assessment for oral urgent treatment in Primary Healthcare: a cross-sectional study.

作者信息

Ramos Danielle Viana Ribeiro, Miraglia João Luiz, Monteiro Camila Nascimento, Borchardt Danielle, Tribis Leonardo, Sanchez Thais Paragis, Bonfim Daiana, da Costa Palacio Danielle, da Luz Rosário de Souza Maria, de Brito Mota Marília Jesus Batista

机构信息

Hospital Israelita Albert Einstein, São Paulo, Brazil.

Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Campinas, Brazil.

出版信息

BMC Health Serv Res. 2020 Nov 4;20(1):1012. doi: 10.1186/s12913-020-05859-2.

DOI:10.1186/s12913-020-05859-2
PMID:33148246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7643441/
Abstract

BACKGROUND

The World Health Organization has advocated for the integration of dental care into the primary healthcare (PHC) setting, including oral urgent treatment (OUT). However, the knowledge necessary for OUT implementation in this setting is still limited. Thus, this study aimed to describe the impact of the implementation of oral disease risk assessment tools for oral health management in PHC.

METHODS

This was a cross-sectional study that included individuals served by a single public PHC unit, with integrated oral healthcare teams, located in the south region of the city of São Paulo, Brazil, between April of 2015 and March of 2017. Data were collected from dental records. Three co-primary endpoints: same day treatment offered, first future appointment scheduled fulfilled, and treatment plan completed were compared before and after the implementation of oral disease risk assessment for OUT.

RESULTS

A total of 1214 individuals that sought OUT, 599 before and 615 after the implementation of oral disease risk assessment for OUT were included in the study. All three co-primary endpoints had significant changes after the implementation of oral disease risk assessment for OUT. Individuals were significantly more likely to be offered same day treatment after (39.9%; 95% CI:36.0-43.9%) than before (9.4%; 95% CI: 7.2-12.0%), to fulfill their first future appointment scheduled after (34.9%; 95% CI:31.1-38.8%) than before (20.7%; 95% CI: 17.5-24.2%), and to have their treatment plan completed after (14.3%; 95% CI:11.6-17.4%) than before (10.0%; 95% CI: 7.7-12.7%) the intervention.

CONCLUSIONS

This study provided evidence of the positive impact oral disease risk assessment tools could have in the organization of OUT in PHC settings.

摘要

背景

世界卫生组织倡导将牙科护理纳入初级卫生保健(PHC)体系,包括口腔急症治疗(OUT)。然而,在这种情况下实施OUT所需的知识仍然有限。因此,本研究旨在描述在初级卫生保健中实施口腔疾病风险评估工具对口腔健康管理的影响。

方法

这是一项横断面研究,研究对象为巴西圣保罗市南部一个设有综合口腔医疗团队的单一公共初级卫生保健单位在2015年4月至2017年3月期间服务的个体。数据从牙科记录中收集。比较了在实施OUT口腔疾病风险评估前后三个共同主要终点:提供当日治疗、首次预约的未来预约完成以及治疗计划完成情况。

结果

本研究共纳入1214名寻求OUT的个体,其中599名在实施OUT口腔疾病风险评估前,615名在实施后。在实施OUT口腔疾病风险评估后,所有三个共同主要终点均有显著变化。与之前(9.4%;95%置信区间:7.2 - 12.0%)相比,实施后个体更有可能获得当日治疗(39.9%;95%置信区间:36.0 - 43.9%),更有可能完成首次预约的未来预约(34.9%;95%置信区间:31.1 - 38.8%),而之前为(20.7%;95%置信区间:17.5 - 24.2%),并且与干预前(10.0%;95%置信区间:7.7 - 12.7%)相比,实施后治疗计划完成的比例更高(14.3%;95%置信区间:11.6 - 17.4%)。

结论

本研究提供了证据,证明口腔疾病风险评估工具在初级卫生保健环境中组织OUT方面可能具有积极影响。

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本文引用的文献

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Integration of oral health into primary health care: A systematic review.将口腔健康纳入初级卫生保健:一项系统综述。
J Family Med Prim Care. 2019 Jun;8(6):1838-1845. doi: 10.4103/jfmpc.jfmpc_286_19.
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Ending the neglect of global oral health: time for radical action.终结全球口腔健康忽视:采取激进行动的时候到了。
Lancet. 2019 Jul 20;394(10194):261-272. doi: 10.1016/S0140-6736(19)31133-X.
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Oral diseases: a global public health challenge.口腔疾病:全球公共健康挑战。
Lancet. 2019 Jul 20;394(10194):249-260. doi: 10.1016/S0140-6736(19)31146-8.
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Time trend of Family Health Strategy coverage in Brazil, its Regions and Federative Units, 2006-2016.2006 - 2016年巴西家庭健康战略覆盖范围在其各地区及联邦单位的时间趋势
Epidemiol Serv Saude. 2018 Sep 3;27(3):e2017170. doi: 10.5123/S1679-49742018000300008.
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Burden of disease in Brazil, 1990-2016: a systematic subnational analysis for the Global Burden of Disease Study 2016.巴西疾病负担,1990-2016 年:2016 年全球疾病负担研究的系统次国家级分析。
Lancet. 2018 Sep 1;392(10149):760-775. doi: 10.1016/S0140-6736(18)31221-2. Epub 2018 Jul 20.
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Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors.1990 - 2015年195个国家口腔疾病的全球、区域和国家患病率、发病率及伤残调整生命年:全球疾病、伤害及风险因素负担的系统分析
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Relationship between risk classifications used to organize the demand for oral health in a small city of São Paulo, Brazil.巴西圣保罗一座小城市中用于组织口腔健康需求的风险分类之间的关系。
Cien Saude Colet. 2017 Jun;22(6):1905-1911. doi: 10.1590/1413-81232017226.00702016.
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Oral health policy in Brazil between 2003 and 2014: scenarios, proposals, actions, and outcomes.2003年至2014年间巴西的口腔健康政策:情况、提议、行动及成果
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Access to urgent dental care: a scoping review.获得紧急牙科护理:一项范围综述。
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