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英国牙科专科医生队伍及其分布:专科地图

Dental specialist workforce and distribution in the United Kingdom: a specialist map.

作者信息

Jo Olivia, Kruger Estie, Tennant Marc

机构信息

School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Australia.

Department of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Nedlands, Perth, 6009, Australia; International Research Collaborative Oral Health and Equity, University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Australia.

出版信息

Br Dent J. 2021 Jul 8. doi: 10.1038/s41415-021-3167-9.

Abstract

Objectives To illustrate, identify and assess a contemporary model of the geographic distribution of specialist dentists in relation to population age groups and rurality.Methods All UK dental specialists registered with the General Dental Council were extracted and paired with publicly available locations of work. Geographic information system tools were used to map specialist locations against population and rural-urban classifications of England, Wales, Scotland and Northern Ireland. The latest 2019 population estimates and health board areas were superimposed to create a specialist map. All other data were collected at the smallest geographic statistical areas and corresponding population data from the latest census.Results A total of 4,439 specialist titles were held by 3,041 individuals, linked to 3,459 unique locations of work. Specialist locations were mapped against 135 Clinical Commissioning Groups (CCGs) of England, seven Local Health Boards of Wales, 14 Health Boards of Scotland and five Health and Social Care Trusts of Northern Ireland. NHS Central London CCG had the highest specialist dentists per 100,000 people at 118.9; paediatric dentists per 20,000 children at 6.4; orthodontic dentists per 20,000 schoolchildren at 23.2; oral surgery dentists at 4.8 per 20,000 adults; and prosthodontic dentists at 7.2 per 20,000 adults. Orthodontics and oral surgery had the highest specialist-to-population ratios at 1:45,545 and 1:77,510, compared to oral and maxillofacial radiology and oral microbiology with the lowest ratios of 1:2,178,316 and 1:9,024,452, respectively. In England, Wales, Scotland and Northern Ireland, there were 79.5% (n = 42,140,039), 55.6% (n = 1,703,248), 46.9% (n = 2,481,996) and 42.9% (n = 776,295) of the respective populations that lived within 2.5 km of a specialist location. There were significant disparities in rural proximity to specialist locations across all nations. In Scotland, 40.8% of the rural population lived outside 10 km of a specialist location.Conclusions Stark inequalities exist in the geographic distribution of UK specialist dentists and high disparities were found in accessing a specialist, especially for vulnerable populations.

摘要

目标 阐述、识别和评估与人口年龄组及乡村性相关的专科牙医地理分布的当代模型。

方法 提取所有在英国牙科总会注册的牙科专科医生,并将其与公开的工作地点进行配对。使用地理信息系统工具,根据英格兰、威尔士、苏格兰和北爱尔兰的人口及城乡分类来绘制专科医生的地点分布图。叠加最新的2019年人口估计数和卫生委员会区域,以创建专科医生地图。所有其他数据均在最小地理统计区域收集,并从最新人口普查中获取相应的人口数据。

结果 3041人共持有4439个专科头衔,与3459个独特的工作地点相关联。专科医生地点是根据英格兰的135个临床委托小组(CCG)、威尔士的7个地方卫生委员会、苏格兰的14个卫生委员会以及北爱尔兰的5个卫生和社会护理信托绘制的。伦敦市中心国民保健服务CCG每10万人中的专科牙医数量最高,为118.9人;每2万名儿童中的儿科牙医为6.4人;每2万名学童中的正畸牙医为23.2人;每2万名成年人中的口腔外科牙医为4.8人;每2万名成年人中的修复牙医为7.2人。正畸和口腔外科的专科医生与人口比例最高,分别为1:45545和1:77510,而口腔颌面放射学和口腔微生物学的比例最低,分别为1:2178316和1:9024452。在英格兰、威尔士、苏格兰和北爱尔兰,分别有79.5%(n = 42140039)、55.6%(n = 1703248)、46.9%(n = 2481996)和42.9%(n = 776295)的人口居住在距离专科医生地点2.5公里范围内。所有国家在农村地区与专科医生地点的接近程度上存在显著差异。在苏格兰,40.8%的农村人口居住在距离专科医生地点10公里以外。

结论 英国专科牙医的地理分布存在明显不平等,在获得专科医生服务方面存在很大差距,尤其是对弱势群体而言。

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