Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
Menzies School of Health Research, Alice Springs, Northern Territory, Australia.
BMC Oral Health. 2023 Apr 4;23(1):201. doi: 10.1186/s12903-023-02886-3.
The purpose of the study was to explore, analyse, and describe the patterns of public dental service utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the individual and contextual levels.
Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent profile analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the individual and contextual level correlates of the identified utilisation patterns.
Six distinct profiles of public dental service utilisation were identified among the study population (n = 25,542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a significant association with refugee utilisation pattern: at the individual-level - demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card; at the contextual-level - characteristics of refugees' neighbourhood of residence including urbanicity, socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel.
The study represents a significant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study findings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups.
本研究旨在探索、分析和描述澳大利亚维多利亚州难民群体对公共牙科服务的利用模式，并确定个人和环境层面的预测因素。
从牙科健康计划数据集收集了 2016 年 7 月至 2020 年 6 月期间在维多利亚州公共牙科服务就诊的难民数据。采用潜在剖面分析方法，根据描述在研究期间接受的牙科服务属性和护理提供地点的六个指标变量，确定难民客户群体中具有相似平均利用模式的离散群体。采用多水平多项逻辑回归分析方法，检验确定的利用模式的个体和环境层面相关性。
在研究人群（n=25542）中确定了六种不同的公共牙科服务利用模式。最大的一组是主要在常规护理过程中使用修复服务的难民（38.10%），其次是在紧急护理过程中使用拔牙服务的难民（23.50%）。只有一小部分被估计为在常规护理过程中更频繁地使用预防性服务（9.10%）。多水平分析显示，以下变量与难民利用模式具有显著关联：个体层面上——包括年龄、性别、出生地、首选交流语言、使用语言翻译服务和资格卡类型等人口统计学和种族属性；环境层面上——包括难民居住社区的特征，如城市性、社会经济劣势、社区卫生中心提供的难民健康计划，以及通过驾驶和公共交通模式到达公共牙科服务的空间可达性。
本研究是朝着制定维多利亚州难民公共牙科服务利用循证知识迈出的重要一步。总体而言，研究结果重申了针对难民群体制定有针对性战略的重要性，以促进定期牙科就诊、口腔疾病预防和及时干预的重要性。
