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感染顾虑和经济负担:新冠疫情期间牙医的预约取消情况。

Infection Concerns and Economic Burden: Dentists' Cancellations During COVID-19.

机构信息

University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany.

University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair for Quality Development in Rehabilitation, Cologne, Germany.

出版信息

Int Dent J. 2024 Apr;74(2):276-283. doi: 10.1016/j.identj.2023.09.004. Epub 2023 Nov 14.

Abstract

OBJECTIVES

During the COVID-19 pandemic, dental appointments were cancelled or postponed by both patients and dentists. This study investigated the associations between German dentists' concerns on cross infection and their emotional burden due to personal economic impact on dentist-initiated appointment cancellations.

METHODS

Data were collected using an anonymous cross-sectional online survey of outpatient physicians in Germany from March through April 2020. Dental treatments were divided into 3 treatment categories (plannable treatments, acute treatments without COVID-19-like symptoms, and acute treatments with COVID-19-like symptoms). Descriptive analyses and multivariate logistic regression models were performed.

RESULTS

A sample of 269 self-employed dentists was considered. Cancellations of prophylaxis appointments were reported by 82% of dentists, whilst 49% reported cancellations of appointments for acute complaints with simultaneous patient-side COVID-19-like symptoms. Further, 58% of respondents stated high or very high concerns about COVID-19 self-infection; 81% stated to be emotionally burdened by the personal economic impact. Dentists' concern of infecting themselves significantly decreased the likelihood of maintaining appointments, with odds ratios of 0.635 (95% confidence interval [CI], 0.426 to 0.932) for plannable treatments and 0.587 (95% CI, 0.367 to 0.916) for treatments of patients with acute complaints and simultaneous COVID-19-like symptoms. In addition, there was a significant negative association between dentists who reported emotional distress due to personal economic impact and the likelihood to maintain appointments, with odds ratios of 0.291 (95% CI, 0.123 to 0.695) for plannable treatments and 0.231 (95% CI, 0.053; 0.706) for treatments of patients without acute complaints and simultaneous COVID-19-like symptoms.

CONCLUSION

Dentists' fear of infecting themselves with COVID-19 played a role in terms of practice-related appointment cancellations. Dentists differentiated their appointment cancellations according to different treatment categories and patient needs. If dental care is to be maintained in pandemic times, physicians' personal factors such as concerns about infection and perceived pandemic-related personal economic impact need to be considered.

摘要

目的

在 COVID-19 大流行期间,患者和牙医均取消或推迟了牙科预约。本研究调查了德国牙医对交叉感染的担忧与其因牙医主动取消预约而对个人经济的影响所带来的情绪负担之间的关联。

方法

本项研究于 2020 年 3 月至 4 月期间通过匿名横断面在线调查收集了德国门诊医师的数据。牙科治疗分为 3 个治疗类别(可计划治疗、无 COVID-19 样症状的急性治疗和有 COVID-19 样症状的急性治疗)。进行了描述性分析和多变量逻辑回归模型分析。

结果

共考虑了 269 名自雇牙医的样本。82%的牙医报告预防性预约被取消,而 49%的牙医报告取消了同时伴有患者侧 COVID-19 样症状的急性投诉预约。此外,58%的受访者表示对 COVID-19 自我感染高度或非常关注;81%的受访者表示对个人经济影响感到情绪负担。牙医对自身感染的担忧显著降低了维持预约的可能性,对于可计划治疗,比值比(OR)为 0.635(95%置信区间[CI],0.426 至 0.932),对于有急性投诉且同时有 COVID-19 样症状的患者,OR 为 0.587(95%CI,0.367 至 0.916)。此外,因个人经济影响而感到情绪困扰的牙医与维持预约的可能性之间存在显著负相关,对于可计划治疗,OR 为 0.291(95%CI,0.123 至 0.695),对于无急性投诉且同时有 COVID-19 样症状的患者,OR 为 0.231(95%CI,0.053;0.706)。

结论

牙医对自身感染 COVID-19 的恐惧在实践相关预约取消方面发挥了作用。牙医根据不同的治疗类别和患者需求来区分他们的预约取消。如果要在大流行期间维持牙科护理,就需要考虑医生的个人因素,如对感染的担忧和对大流行相关个人经济影响的看法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9c7/10988247/14aaeefeae19/gr1.jpg

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