Wang Qingyu, Qu Xing, Houser Shannon H, Zhang Yan, Tian Meirong, Zhang Qiong, Zhang Wei
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
HEOA Group, Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, People's Republic of China.
Risk Manag Healthc Policy. 2022 Sep 3;15:1641-1650. doi: 10.2147/RMHP.S362004. eCollection 2022.
Limited information is known about dental implementation by pediatric primary care physicians (PCPs) at the primary care level in China. This study aimed to explore the current status of primary oral care implementation and related influencing factors.
A cross-sectional survey was conducted among PCPs in Sichuan Province, China. Multivariable logistic regression was used to analyse factors associated with CRA and dental referral for high caries-risk children.
A total of 504 out of 524 questionnaires remained for analysis. In all, 93.8% of PCPs reported that they usually or sometimes performed dental screening for children, 31.3% performed CRA, and 49.0% referred high caries-risk children to dentists. More CRA activities were associated with PCPs who encountered a greater number of children with caries during systematic care (adjusted OR: 2.37, 95% CI:[1.08,5.18], had dental knowledge training by pediatric dentists (aOR: 2.26, 95% CI:[1.36, 3.75], and learned pediatric dental knowledge on their own (aOR: 2.87, 95% CI: [1.51, 5.45]). In addition to the above associators, a higher rate of dental referrals for high caries-risk children was associated with having a dental department in the same work institute (aOR: 1.72, 95% CI: [1.09, 2.70] and having more confidence in their dental knowledge (aOR: 1.29, 95% CI: [1.04, 1.61]).
Paediatric PCPs commonly implement dental screening but perform fewer CRAs and dental referrals for high caries-risk children during systematic health management in western China. To increase CRA activities and dental referral by paediatric PCPs, health policymakers could encourage interdisciplinary cooperation between dental professionals and paediatric PCPs.
在中国基层医疗层面,关于儿科初级保健医生(PCP)开展口腔医疗服务的信息有限。本研究旨在探讨基层口腔保健实施的现状及相关影响因素。
对中国四川省的初级保健医生进行了一项横断面调查。采用多变量逻辑回归分析与高龋风险儿童的龋病风险评估(CRA)及牙科转诊相关的因素。
524份问卷中共有504份可供分析。总体而言,93.8%的初级保健医生报告称他们通常或有时会为儿童进行口腔筛查,31.3%进行龋病风险评估,49.0%会将高龋风险儿童转诊至牙医处。更多的龋病风险评估活动与在系统保健期间遇到更多龋病儿童的初级保健医生相关(调整比值比:2.37,95%置信区间:[1.08, 5.18]),接受过儿科牙医的口腔知识培训(调整后比值比:2.26,95%置信区间:[1.36, 3.75]),以及自行学习过儿科口腔知识(调整后比值比:2.87,95%置信区间:[1.51, 5.45])。除上述关联因素外,高龋风险儿童更高的牙科转诊率与同一工作机构设有牙科科室(调整后比值比:1.72,95%置信区间:[1.09, 2.70])以及对自身口腔知识更有信心(调整后比值比:1.29,95%置信区间:[1.04, 1.61])相关。
在中国西部,儿科初级保健医生在系统健康管理期间通常会开展口腔筛查,但对高龋风险儿童进行的龋病风险评估和牙科转诊较少。为增加儿科初级保健医生的龋病风险评估活动和牙科转诊,卫生政策制定者可鼓励牙科专业人员与儿科初级保健医生之间的跨学科合作。