Moore Richard J, Pretty Iain, Douglas Gail V A, Mighell Alan J
Division of Oral Surgery and Oral Medicine, University of Leeds, UK.
School of Dentistry, University of Manchester, UK.
Br Dent J. 2023 Feb 17:1-6. doi: 10.1038/s41415-023-5526-1.
Aims This study aimed to use electronic referral management system (eRMS) oral surgery data across multiple sites in England to evaluate the service over a 34-month period in relation to: 1) pre- and post-pandemic referral rates in oral surgery; 2) examining the data for signs of inequality in obtaining a referral for oral surgery; and 3) considering the impact on service provision for oral surgery in England.Methods Oral surgery referral data were available from an eRMS for areas of England covered by this service for the 34-month period of March 2019 to December 2021 (inclusive), which included 12 months of pre-pandemic data and the first 22 months of the pandemic. The data were from the following regions in England: Central Midlands; Cheshire and Merseyside; East Anglia and Essex; Greater Manchester; Lancashire; Thames Valley; and Yorkshire and the Humber.Results The total number of referrals received was 1,766,895 during this 34-month period, with pre-pandemic referral levels averaging at 25,498 per month, with a reduction to 698 per month in April 2020. Referrals have risen to a peak of 217,646 for the month of November 2021. An average of 1.5% of referrals were rejected pre-pandemic, compared with 2.7% per month post-pandemic.Discussion Pre-pandemic referral numbers were predictably stable within a narrow range which have then increased dramatically post-pandemic. The variations in oral surgery referral patterns place significant strain on oral surgery services across England. This not only has consequences on the patient experience, but also on workforce and workforce development, to ensure that there is not a long-term destabilising impact.Conclusion Analysis of 1.75 million referrals to oral surgery services in England has highlighted the ongoing impact of the pandemic and the need to actively minimise adverse impacts on patients, NHS services and the workforce.
目的 本研究旨在利用电子转诊管理系统（eRMS）中英格兰多个地点的口腔外科数据，评估34个月期间该服务的情况，具体涉及：1）口腔外科大流行前和大流行后的转诊率；2）检查数据中获取口腔外科转诊方面的不平等迹象；3）考虑对英格兰口腔外科服务提供的影响。
方法 可从eRMS获取2019年3月至2021年12月（含）这34个月期间该服务覆盖的英格兰地区的口腔外科转诊数据，其中包括大流行前的12个月数据和大流行的前22个月数据。数据来自英格兰以下地区：中部地区；柴郡和默西塞德郡；东安格利亚和埃塞克斯；大曼彻斯特；兰开夏郡；泰晤士河谷；约克郡和亨伯赛德郡。
结果 在这34个月期间共收到1,766,895次转诊，大流行前转诊水平平均每月25,498次，2020年4月降至每月698次。转诊量在2021年11月达到峰值217,646次。大流行前平均1.5%的转诊被拒绝，大流行后为每月2.7%。
讨论 正如预期的那样，大流行前转诊数量在狭窄范围内保持稳定，之后在大流行后急剧增加。口腔外科转诊模式的变化给英格兰各地的口腔外科服务带来了巨大压力。这不仅对患者体验有影响，也对劳动力及劳动力发展有影响，以确保不会产生长期的不稳定影响。
结论 对英格兰175万例口腔外科服务转诊的分析突出了大流行的持续影响，以及积极尽量减少对患者、国民保健服务体系（NHS）服务和劳动力的不利影响的必要性。
