Department of Health Care Management, School of Health Management and Information Science, Shiraz University of Medical Science, Shiraz, Iran.
College of Business, Government and Law, Flinders University, Adelaide, SA, 5042, Australia.
BMC Oral Health. 2024 Aug 20;24(1):965. doi: 10.1186/s12903-024-04734-4.
Oral health is essential for overall well-being and can significantly improve quality of life. However, people with special health care needs (SHCN) often face challenges in accessing dental services. This study aimed to systematically review all available evidence on the oral and dental service utilization determinants among these individuals. Based on the findings, we also explore strategies to increase their access to dental care.
This study is a systematic review of reviews based on the PRISMA 2020. Six databases were systematically searched including PubMed, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library. Related keywords were applied up to 30 October 2023. This study includes all systematic, scoping, and rapid reviews written in English that examine the factors affecting dental service use among SHCNs. Microsoft Power BI was used for descriptive quantitative analysis, and MAXQDA version 10 was applied for qualitative thematic analysis.
The number of 2238 articles were retrieved based on the search strategy. After excluding duplications and appraising the eligibility, 7 articles were included. An examination of these 7 articles shows that they were all carried out from 2016 to 2022. Of these, 42% were systematic reviews, 42% used a scoping method, and one study (14%) was a rapid review. According to the thematic analysis, there were five main themes concerning determinants of oral and dental utilization of SHCN: "Financial considerations," "Patient-Provider Relationship," "Accessibility and Availability of Services," "Patient Factors," and "Quality of Care." Additionally, regarding strategies for improving utilization, three main themes emerged: "Education and Training," "Service Improvement," and "Policy Solutions.
This study delves into the intricate challenges SHCNs face in accessing dental services, highlighting the imperative for comprehensive interventions addressing supply and demand. Supply-oriented measures encompass dentist education, implementing financial policies for affordable services, and integrating dental care into primary healthcare systems. On the demand side, strategies revolve around empowering patients and caregivers and enhancing cultural inclusivity. Despite sustained efforts, current utilization rates fall short of optimal levels. Thus, effective strategic planning by policymakers and healthcare leaders is paramount to bolster dental service utilization among SHCNs, thereby enhancing their overall well-being.
口腔健康对整体健康至关重要，可显著提高生活质量。然而，特殊医疗保健需求人群（SHCN）在获得牙科服务方面常常面临挑战。本研究旨在系统综述现有关于这些人群口腔和牙科服务利用决定因素的所有证据。基于研究结果，我们还探讨了增加其获得牙科护理的策略。
本研究是基于 PRISMA 2020 的系统综述。共检索了六个数据库，包括 PubMed、Web of Science、Scopus、Embase、ProQuest 和 Cochrane Library，检索词应用至 2023 年 10 月 30 日。本研究纳入所有以英语撰写的系统综述、范围综述和快速综述，旨在检查影响 SHCN 牙科服务利用的因素。采用 Microsoft Power BI 进行描述性定量分析，使用 MAXQDA 版本 10 进行定性主题分析。
基于检索策略，共检索到 2238 篇文章，经排除重复和评估资格后，纳入 7 篇文章。对这 7 篇文章的审查表明，它们均在 2016 年至 2022 年期间进行。其中，42%为系统综述，42%使用范围方法，一项研究（14%）为快速综述。根据主题分析，有五个主要主题涉及 SHCN 口腔和牙科利用的决定因素：“财务考虑”、“医患关系”、“服务的可及性和可用性”、“患者因素”和“护理质量”。此外，关于提高利用率的策略，有三个主要主题：“教育和培训”、“服务改进”和“政策解决方案”。
本研究深入探讨了 SHCN 在获得牙科服务方面面临的复杂挑战，强调了全面干预措施应对供应和需求的重要性。供应方面的措施包括牙医教育、实施经济实惠服务的财务政策以及将牙科护理纳入初级保健系统。在需求方面，策略包括赋予患者和照顾者权力以及增强文化包容性。尽管做出了持续努力，但目前的利用率仍未达到最佳水平。因此，政策制定者和医疗保健领导者制定有效的战略规划对于增强 SHCN 对牙科服务的利用、提高其整体健康水平至关重要。
