英国软饮料行业征税对儿童因龋齿拔牙而住院的预估影响：中断时间序列分析
Estimated impact of the UK soft drinks industry levy on childhood hospital admissions for carious tooth extractions: interrupted time series analysis.
作者信息
Rogers Nina Trivedy, Conway David I, Mytton Oliver, Roberts Chrissy H, Rutter Harry, Sherriff Andrea, White Martin, Adams Jean
机构信息
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
出版信息
BMJ Nutr Prev Health. 2023 Dec;6(2):243-252. doi: 10.1136/bmjnph-2023-000714. Epub 2023 Nov 14.
INTRODUCTION
Tooth extraction due to dental caries is associated with socioeconomic deprivation and is a major reason for elective childhood hospital admissions in England. Consumption of sugar-sweetened beverages is a risk factor for dental caries. We examined whether the soft drinks industry levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in incidence rates of hospital admissions for carious tooth extraction in children, 22 months post-SDIL implementation.
METHODS
Changes in incidence rates of monthly National Health Service hospital admissions for extraction of teeth due to a primary diagnosis of dental caries (International Classification of Diseases; ICD-10 code: K02) in England, between January 2012 and February 2020, were estimated using interrupted time series and compared with a counterfactual scenario where SDIL was not announced or implemented. Periodical changes in admissions, autocorrelation and population structure were accounted for. Estimates were calculated overall, by Index of Multiple Deprivation (IMD) fifths and by age group (0-4 years, 5-9 years, 10-14 years, 15-18 years).
RESULTS
Compared with the counterfactual scenario, there was a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0-18 years). Children aged 0-4 years and 5-9 years had relative reductions of 28.6% (95% CI 35.6% to 21.5%) and 5.5% (95% CI 10.5% to 0.5%), respectively; no change was observed for older children. Reductions were observed in children living in most IMD areas regardless of deprivation.
CONCLUSION
The UK SDIL was associated with reductions in incidence rates of childhood hospital admissions for carious tooth extractions, across most areas regardless of deprivation status and especially in younger children.
TRIAL REGISTRATION NUMBER
ISRCTN18042742.
引言
因龋齿而拔牙与社会经济贫困相关，并且是英格兰儿童择期住院的主要原因。饮用含糖饮料是龋齿的一个风险因素。我们研究了2016年3月宣布并于2018年4月实施的软饮料行业税（SDIL），与SDIL实施22个月后儿童因龋齿拔牙的住院发病率变化是否相关。
方法
采用中断时间序列估计2012年1月至2020年2月期间英格兰因龋齿（国际疾病分类；ICD - 10编码：K02）作为主要诊断而进行拔牙的每月国民健康服务医院住院发病率变化，并与未宣布或实施SDIL的反事实情景进行比较。考虑了住院的周期性变化、自相关和人口结构。总体、按多重贫困指数（IMD）五分位数以及年龄组（0 - 4岁、5 - 9岁、10 - 14岁、15 - 18岁）计算估计值。
结果
与反事实情景相比，所有儿童（0 - 18岁）因龋齿拔牙的住院人数相对减少了12.1%（95%可信区间17.0%至7.2%）。0 - 4岁和5 - 9岁儿童的相对减少率分别为28.6%（95%可信区间35.6%至21.5%）和5.5%（95%可信区间10.5%至0.5%）；年龄较大的儿童未观察到变化。在大多数IMD地区生活的儿童中，无论贫困程度如何，住院人数均有所减少。
结论
英国的SDIL与儿童因龋齿拔牙的住院发病率降低相关，在大多数地区，无论贫困状况如何，尤其是在年幼儿童中。
试验注册号
ISRCTN18042742。
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