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残疾人获得口腔门诊医疗服务的机会不平等:一项回顾性队列研究。

Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study.

机构信息

Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea.

Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan Dearo, Iksan, 54538, North Jula, Korea.

出版信息

BMC Oral Health. 2023 Apr 14;23(1):213. doi: 10.1186/s12903-023-02948-6.

Abstract

BACKGROUND

People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities.

METHODS

Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002-2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated.

RESULTS

The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among older individuals (p < 0.001). The proportion and frequency of annual dental visits was lower among women than among men with disabilities. RSDC had differential effects on the severity of disability. Compared to people without disabilities, RSDC increased the number of annual dental visits (p = 0.067) and the dental expenses per visit (p < 0.05) among those with severe disabilities, but the effect on the number of annual dental visits was not significant among those with mild disabilities (p = 0.698).

CONCLUSIONS

Our results suggest a need for a special dental care system for people with disabilities, to ensure an RSDC, particularly for women and for older people with disabilities.

摘要

背景

残疾人在口腔健康管理和获得牙科护理方面面临困难。是否有常规的牙科医疗服务来源(RSDC)是影响获得卫生服务和护理管理的一个重要因素。本研究的目的是确定 RSDC 的可用性对残疾人群每年看牙次数和每次看牙费用的影响。

方法

使用韩国 2002-2018 年国家健康保险索赔数据,对 7896251 名有牙齿问题的患者进行数据分析。采用广义估计方程分析重复测量数据,并评估 RSDC 与残疾严重程度之间的交互作用。

结果

有残疾的患者(2.62)每年看牙次数高于无残疾的患者(2.23)。尽管残疾患者的牙科需求增加,但年龄较大的患者(p<0.001)每年看牙次数和每次看牙费用均较低。与男性残疾患者相比,女性残疾患者每年看牙的比例和频率较低。RSDC 对残疾严重程度有不同的影响。与无残疾者相比,RSDC 增加了严重残疾者每年看牙的次数(p=0.067)和每次看牙的费用(p<0.05),但对轻度残疾者每年看牙的次数影响不显著(p=0.698)。

结论

我们的研究结果表明,需要为残疾人建立特殊的牙科护理系统,以确保他们有常规的牙科医疗服务来源,特别是对女性和残疾程度较高的老年人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f2a/10103483/f412412dd776/12903_2023_2948_Fig1_HTML.jpg

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