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%）。