Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Public Health England, London, UK.
Community Dent Oral Epidemiol. 2021 Aug;49(4):322-329. doi: 10.1111/cdoe.12603. Epub 2020 Dec 4.
Paediatric hospital admissions for dental extractions remain a cause for concern, despite decreasing levels of dental diseases in some areas of the country. While local investigations have taken place, little is known about national patterns, and how the relationship between the number of hospital admissions and key independent variables differs across England. The aim of this study was to examine spatial differences in the number of paediatric hospital admissions for extractions in relation to four key independent variables: dental caries, deprivation, units of dental activity and child access to dentists.
Hospital admissions data (for all dental-related reasons) were taken from the Hospital Episode Statistics (HES) for England (2017/18) for children and adolescents aged up to 19 years. All data were collected at local authority level. Geographically weighted regression was used to examine associations between the number of hospital admissions and the independent variables, as well as the strength of these associations and how they differed spatially.
Geographically weighted regression revealed considerable differences in the associations between the number of paediatric hospital admissions and the independent variables across England, with distinct regional clusters identified in the data. Some areas exhibited positive associations between independent variables and the number of hospital admissions, such as in Yorkshire and areas of south-west, south-east and north-west England, where greater mean dmft scores were associated with greater numbers of hospital admissions. Negative associations were also found, such as in south-west, north-west and North East England, where higher deprivation scores were associated with lower admission numbers. Despite the patterns found, a much smaller sample of the associations between the independent variables and the number of hospital admissions was statistically significant.
This analysis allows for a better understanding of the spatial associations between the number of hospital admissions and key independent variables, as well as how changes to these independent variables may affect the number of admissions in each local authority. These findings should be considered in the context of the limitations of HES dataset.
尽管该国某些地区的口腔疾病发病率有所下降，但儿科医院因拔牙而住院的情况仍令人担忧。虽然已经进行了一些本地调查，但对全国范围内的模式以及医院住院人数与关键自变量之间的关系如何因英格兰各地而异却知之甚少。本研究的目的是研究与四个关键自变量（龋齿、贫困、牙科活动单位和儿童看牙医的机会）相关的拔牙儿童住院人数的空间差异。
从英格兰的医院入院统计数据（HES）中获取了 2017/18 年 19 岁以下儿童和青少年的所有与牙科相关的原因的住院数据。所有数据均按地方当局级别收集。地理加权回归用于检查住院人数与自变量之间的关联，以及这些关联的强度及其在空间上的差异。
地理加权回归揭示了英格兰各地儿科住院人数与自变量之间的关联存在相当大的差异，数据中确定了明显的区域聚类。在一些地区，自变量与住院人数之间存在正相关关系，例如在约克郡和英格兰西南部、东南部和西北部地区，平均 dmft 评分较高与住院人数较多相关。也发现了负相关关系，例如在英格兰西南部、西北部和东北部地区，贫困程度较高与住院人数较低相关。尽管发现了这些模式，但自变量与住院人数之间的关联中只有一小部分具有统计学意义。
这项分析可以更好地了解住院人数与关键自变量之间的空间关联，以及这些自变量的变化如何影响每个地方当局的住院人数。这些发现应结合 HES 数据集的局限性进行考虑。
