Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA.
Public Policy Center, University of Iowa, Iowa City, IA, USA.
J Am Med Dir Assoc. 2021 Jun;22(6):1194-1198. doi: 10.1016/j.jamda.2021.02.012. Epub 2021 Mar 17.
This study uses a national model of community-based long-term services and supports, the Program of All-inclusive Care for the Elderly (PACE), to identify organizational structures and protocols that can facilitate the delivery of dental examinations.
We developed an online survey instrument and conceptual model for this study representing 10 domains believed to characterize a quality PACE dental program.
The Qualtrics survey was distributed nationally to all 124 PACE programs in the 31 states PACE was available. Respondents in this study represented 35 programs (program response rate = 28.2%) in 23 states (state response rate = 74.2%).
Selected independent variables from each of the 10 domains were tested against the reported delivery of dental examinations variable using the Kendall τ and χ. Twenty-nine programs were included in the final analysis.
Most programs mandated a dental examination within 31-60 days of enrollment (63.6%). Few programs had a dental manual (15.6%) or any quality assurance for dental care (32.3%). A majority of programs (58.8%) stated that they had a protocol for enrollees to receive a cleaning every 6-12 months. Having a system for quality assurance for dental care, protocol for a cleaning every 6-12 months, mandating a comprehensive dental examination and providing preventive dental services onsite with built-in equipment, were all statistically associated with a higher reported delivery of dental examinations.
Organizations providing long-term services and supports, including PACE, can use these identified domains to develop minimal standards to ensure dental care is part of innovative models of community-based long-term services and supports. Implementing these domains can facilitate effective delivery of dental examinations that have the potential to support positive oral health and general health outcomes.
本研究利用基于社区的长期服务和支持的国家模式，即老年人全面护理计划（PACE），确定可以促进牙科检查提供的组织结构和协议。
我们为这项研究开发了一个在线调查工具和概念模型，代表了 10 个被认为是优质 PACE 牙科项目特征的领域。
该调查在全国范围内分发给所有 31 个州提供 PACE 的 124 个 PACE 计划。本研究的受访者代表了来自 23 个州的 35 个计划（计划回应率为 28.2%）（州回应率为 74.2%）。
从每个 10 个领域中选择了一些独立变量，使用 Kendall τ 和 χ 对报告的牙科检查提供变量进行了测试。有 29 个计划被纳入最终分析。
大多数计划规定在入组后 31-60 天内进行牙科检查（63.6%）。很少有计划有牙科手册（15.6%）或任何牙科护理质量保证（32.3%）。大多数计划（58.8%）表示，他们有一项协议，要求学员每 6-12 个月进行一次清洁。建立牙科护理质量保证系统、每 6-12 个月进行一次清洁的协议、规定全面的牙科检查以及提供带有内置设备的现场预防性牙科服务，均与报告的牙科检查提供量较高有统计学关联。
提供长期服务和支持的组织，包括 PACE，可以使用这些确定的领域来制定最低标准，以确保牙科护理是基于社区的长期服务和支持的创新模式的一部分。实施这些领域可以促进有效的牙科检查提供，这有可能支持积极的口腔健康和总体健康结果。
