Alkhouri Nabih, Sanders Helen, Waite Charlotte, Marshman Zoe, Ashley Paul
Department of Paediatric Dentistry, UCLH Eastman Dental Hospital, London, WC1E 6DG, UK.
Department of Paediatric Dentistry, Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust, B5 7EG, Birmingham, UK.
Br Dent J. 2022 Jul 5:1-6. doi: 10.1038/s41415-022-4455-8.
Introduction Dental general anaesthetic (DGA) remains one of the main modalities to deliver treatment to paediatric patients. The main central registry system which is used as a proxy measure of DGA provision is the Hospital Episode Statistics (HES) data on hospital admission of children for dental extractions. This database does not accurately reflect the number of DGAs as it omits non-hospital-based providers and the data includes treatment under sedation.Aims The aim is to describe the paediatric DGA service provision across England and determine type of provider (NHS Trusts or Community Dental Services [CDSs]), type of lists (extraction or comprehensive care) and the speciality planning the service.Methods Potential providers were identified using the provider-level analysis in HES database (for NHS trusts) and the NHS Business Services Authority and internet-based search engine (for CDS providers). All potential providers were contacted (n = 204) and provided with a pro forma to collect data.Results Response rate was 82% and 115 providers confirmed provision of paediatric DGA. These were mostly NHS trusts (72%). Not all providers appeared in the HES database (25%). Half of the providers provided separate lists for exodontia versus comprehensive care. Only 32% of the lists were planned by specialists in paediatric dentistry. All regions, apart from London, had some comprehensive care lists planned by non-paediatric dentists.Conclusion The results highlighted the inaccuracies in the HES, variation in service provision across England and the lack of paediatric speciality-led DGA services. Paediatric DGA needs to be better recorded and commissioned.
引言
牙科全身麻醉（DGA）仍然是为儿科患者提供治疗的主要方式之一。用作DGA提供情况替代指标的主要中央登记系统是关于儿童因拔牙入院的医院事件统计（HES）数据。该数据库不能准确反映DGA的数量，因为它遗漏了非医院机构的提供者，并且数据包括了镇静下的治疗。
目的
目的是描述英格兰各地的儿科DGA服务提供情况，并确定提供者类型（国民保健服务信托基金或社区牙科服务[CDS]）、清单类型（拔牙或综合护理）以及规划该服务的专业领域。
方法
使用HES数据库中的提供者级别分析（用于国民保健服务信托基金）以及国民保健服务商业服务管理局和基于互联网的搜索引擎（用于CDS提供者）来确定潜在提供者。联系了所有潜在提供者（n = 204），并向他们提供了一份表格以收集数据。
结果
回复率为82%，115个提供者确认提供儿科DGA。这些大多是国民保健服务信托基金（72%）。并非所有提供者都出现在HES数据库中（25%）。一半的提供者为拔牙和综合护理提供了单独的清单。只有32%的清单是由儿科牙科专家规划的。除伦敦外，所有地区都有一些由非儿科牙医规划的综合护理清单。
结论
结果突出了HES中的不准确之处、英格兰各地服务提供的差异以及缺乏儿科专科主导的DGA服务。儿科DGA需要更好地记录和委托安排。
