Wiener R Constance
Department of Dental Public Health and Professional Practice, West Virginia University School of Dentistry, Morgantown, West Virginia, United States of America.
PLOS Glob Public Health. 2023 Feb 21;3(2):e0001540. doi: 10.1371/journal.pgph.0001540. eCollection 2023.
It is important to determine access to preventive care among vulnerable populations. The purpose of this research is to compare preventive dental utilization between children with special healthcare needs (CSHCN) and children without special healthcare needs (CWSHCN) using National Survey of Children's Health, 2020 (NSCH, 2020) data. A cross-sectional study design was used in this secondary data analysis of data from June 2020 to January 2021, NSCH, 2020, a publicly available data set with demographic and healthcare information. Parents/guardians responded to validated questions including one asking them to recall preventive dental services received during the previous year (June 2019 to January 2021). This was a critical time of transition from normal, pre-pandemic activities (June 2019 to March 2020) to the pandemic period (March 2020 to January 2021) with restrictions and no available vaccinations for children. Data analyses for the NSCH, 2020 data included frequency determinations, Chi Square analyses by preventive dental visit, and logistic regression analyses. There were 40,140 children in the sample, and 20.6% were CSHCN. Overall, 75.0% of children received a dental preventive visit. This study had an interaction of CSHCN status and medical visits within the previous year in which having had a medical visit was associated with CSHCN status also having a dental visit; while the CSHCN who did not have a medical visit were less likely to have a dental visit in unadjusted analysis. However, the pattern for CSHCN and the medical visit reversed in adjusted analysis. In adjusted analysis, CWSHCN and a medical visit were the most likely to also have a dental visit during this period. Many factors influenced access to preventive dental care in the months leading up to and including the COVID-19 pandemic. CSHCN with or without a medical visit were less likely to have preventive dental care than CWSHCN with a medical visit in logistic regression analysis adjusted for sex, race/ethnicity, age, smoking in the household, medical visits within the year, insurance coverage, and highest level of education in the household.
确定弱势群体获得预防性医疗服务的情况非常重要。本研究的目的是利用2020年全国儿童健康调查（NSCH，2020）的数据，比较有特殊医疗需求的儿童（CSHCN）和无特殊医疗需求的儿童（CWSHCN）的预防性牙科服务利用率。在对2020年6月至2021年1月NSCH，2020的数据进行的二次数据分析中采用了横断面研究设计，NSCH，2020是一个可公开获取的包含人口统计学和医疗信息的数据集。父母/监护人回答了经过验证的问题，其中一个问题要求他们回忆上一年（2019年6月至2021年1月）接受的预防性牙科服务。这是一个从正常的大流行前活动（2019年6月至2020年3月）过渡到疫情期间（2020年3月至2021年1月）的关键时期，期间有诸多限制，且儿童无法接种疫苗。对NSCH，2020数据的分析包括频率测定、按预防性牙科就诊进行的卡方分析以及逻辑回归分析。样本中有40140名儿童，其中20.6%是CSHCN。总体而言，75.0%的儿童接受了牙科预防性就诊。本研究发现CSHCN状况与上一年的医疗就诊之间存在交互作用，即进行过医疗就诊与CSHCN状况下也进行牙科就诊相关；而在未经调整的分析中，未进行医疗就诊的CSHCN进行牙科就诊的可能性较小。然而，在调整分析中，CSHCN与医疗就诊的模式发生了逆转。在调整分析中，CWSHCN和进行过医疗就诊的情况在此期间最有可能也进行牙科就诊。在包括COVID-19大流行期间及之前的几个月里，许多因素影响了获得预防性牙科护理的机会。在按性别、种族/族裔、年龄、家庭吸烟情况、年内医疗就诊情况、保险覆盖范围和家庭最高教育水平进行调整的逻辑回归分析中，有或没有进行过医疗就诊的CSHCN比有医疗就诊的CWSHCN获得预防性牙科护理的可能性更小。
