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中年人牙科服务的利用:倾向因素、促成因素和需求变量。

Use of dental services among middle-aged adults: predisposing, enabling and need variables.

机构信息

ARCPOH, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Aust Dent J. 2021 Sep;66(3):270-277. doi: 10.1111/adj.12828. Epub 2021 Feb 21.

Abstract

OBJECTIVES

To examine if making a visit, number of visits and services varied by predisposing (gender, perceived health competence, education, previous relief of pain visit), enabling (dental anxiety, income, social support) and need (perceived need, number of teeth and oral pain) characteristics.

METHODS

Dental visiting and services data from a sample of middle-aged South Australian adults were collected from 61% of participants at 12-months (n = 603) and 59% after 24-months (n = 583). Visiting over 2-years, mean visits and mean services were analysed by log binomial and Poison regression using the Andersen and Newman model.

RESULTS

The percentage having a dental visit over 2-years was lower for males than females, prevalence ratio (PR, 95% CI) 0.91 (0.84, 0.99), and for higher than lower dental anxiety, PR = 0.78 (0.62, 0.98). Number of visits was associated with higher than lower income, rate ratio (RR, 95%CI) 1.20 (1.02, 1.41) but lower for those with higher social support, RR = 0.86 (0.74, 0.99). Services were lower for those with higher perceived health competence, RR = 0.72 (0.56, 0.92) but higher for those with perceived needs, RR = 1.22 (1.01, 1.46).

CONCLUSIONS

While need and cost factors predict dental service use, psychosocial variables such as health competence and social support also need to be considered.

摘要

目的

考察就诊、就诊次数和服务利用是否因倾向因素(性别、感知健康能力、教育程度、以往疼痛缓解就诊)、促成因素(牙齿焦虑、收入、社会支持)和需求因素(感知需求、牙齿数量和口腔疼痛)而有所不同。

方法

从南澳大利亚州中年成年人样本中收集了就诊和服务数据,在 12 个月时(n=603)和 24 个月时(n=583)分别有 61%和 59%的参与者完成了调查。使用 Andersen 和 Newman 模型,采用对数二项式和 Poisson 回归分析了 2 年内的就诊率、平均就诊次数和平均服务利用情况。

结果

2 年内男性的就诊率低于女性,患病率比(PR,95%CI)为 0.91(0.84,0.99),而牙齿焦虑程度较高的人就诊率较低,PR 为 0.78(0.62,0.98)。就诊次数与收入较高相关,相对危险比(RR,95%CI)为 1.20(1.02,1.41),但与社会支持较高的人相比,RR 为 0.86(0.74,0.99)。感知健康能力较高的人服务利用率较低,RR 为 0.72(0.56,0.92),而感知需求较高的人服务利用率较高,RR 为 1.22(1.01,1.46)。

结论

尽管需求和费用因素可预测牙科服务的利用情况,但还需要考虑健康能力和社会支持等心理社会变量。

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