19 个国家的国家口腔健康政策和筹资情况以及口腔健康状况。
National Oral Health Policy and Financing and Dental Health Status in 19 Countries.
机构信息
School of Dentistry, University of California, San Francisco, California, USA.
School of Dentistry, Columbia University, New York, New York, USA.
出版信息
Int Dent J. 2023 Jun;73(3):449-455. doi: 10.1016/j.identj.2023.01.007. Epub 2023 Mar 21.
OBJECTIVE
Dental caries in permanent teeth is one of the most common health issues-despite being preventable in early stages-due to inadequate regulation of preventive dental services in many countries. This study evaluates the association between regulation of preventive dental services and oral health outcomes.
METHODS
This mixed-method study analysed data from 19 member countries of the Organisation for Economic Co-operation and Development (OECD). Oral health outcomes were measured using decayed missing and filled teeth (DMFT) indexes for children aged 12 to 18 years. Oral health expenditures were measured as a percentage of each country's gross domestic product (GDP). We conducted web-based research and systematically extracted and coded data on dental policy regarding children's preventive dental services. Preventive care was assessed based on legal policy mandating children receive preventive services, availability of free services for children, and regulation of the services provided. We assessed the relationship amongst oral health policy, outcomes, and expenditure using bivariate regression analysis.
RESULTS
The most common preventive policy category is the availability of free dental services for children (78.95%), and the least common is policy mandating dental services for children (26.32%). The oral health expenditure is correlated with DMFT index (-4.42, P < 0.05). The legal policy mandating dental services for children is correlated with DMFT index (-1.32, P < 0.05) and correlated with average oral health expenditure (0.16, P < 0.05).
CONCLUSIONS
A percentage increase in oral health expenditure is associated with a 4.42 reduction in DMFT. The existence of legal policy mandating dental care for children is associated with a 1.32 reduction in mean DMFT score and a 0.16% increase in oral health expenditure. These findings highlight the importance of preventive care and may aid policymaking and health system reforms.
目的
尽管在许多国家，预防性牙科服务的管理不足，导致恒牙龋齿仍然是最常见的健康问题之一，但这种疾病在早期是可以预防的。本研究评估了预防性牙科服务管理与口腔健康结果之间的关联。
方法
本混合方法研究分析了经济合作与发展组织（OECD）19 个成员国的数据。口腔健康结果使用 12 至 18 岁儿童的龋齿、缺失和填充牙齿（DMFT）指数进行衡量。口腔健康支出以各国国内生产总值（GDP）的百分比衡量。我们进行了网络研究，并系统地提取和编码了有关儿童预防性牙科服务的牙科政策数据。根据法律政策规定儿童接受预防性服务、儿童免费服务的可用性以及所提供服务的监管，评估预防保健。我们使用双变量回归分析评估了口腔健康政策、结果和支出之间的关系。
结果
最常见的预防政策类别是为儿童提供免费牙科服务（78.95%），最不常见的是为儿童提供牙科服务的政策规定（26.32%）。口腔健康支出与 DMFT 指数呈负相关（-4.42，P < 0.05）。法律政策规定为儿童提供牙科服务与 DMFT 指数呈负相关（-1.32，P < 0.05），与平均口腔健康支出呈正相关（0.16，P < 0.05）。
结论
口腔健康支出增加 1%，DMFT 减少 4.42%。为儿童提供牙科保健的法律政策的存在与平均 DMFT 评分降低 1.32 分和口腔健康支出增加 0.16%相关。这些发现强调了预防保健的重要性，并可能有助于制定政策和进行卫生系统改革。
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