Gil-Alzate Diego A, Posada-Zapata Isabel C, Agudelo-Suárez Andrés A
Faculty of Dentistry, University of Antioquia, Medellín 050010, Colombia.
National Faculty of Public Health, University of Antioquia, Medellín 050010, Colombia.
Int J Environ Res Public Health. 2025 Aug 9;22(8):1248. doi: 10.3390/ijerph22081248.
This study aimed to understand, through the voices of patients, the factors that contribute to inequality and inequity in oral healthcare and their implications for patient safety. A qualitative study was performed using a Grounded Theory approach (GT) through 13 in-depth interviews with a flexible design, recorded and transcribed verbatim for study purposes. Open and axial coding and analysis categories were generated, and a conceptual and explicative framework was established. Ethical approval was obtained. The main findings highlighted how individual, social, and contextual factors significantly influence the materialization of risks and failures in oral healthcare, ultimately affecting patient safety in dental practice. These factors include individual factors, the relationship between professionals and patients, and failures in healthcare service provision. Participants' discourses showed examples of inequities, such as gender, socioeconomic gradient, educative level, type of healthcare system, discrimination, stigmatization, and othering-otherness, and their effect on dental care and dentistry safety. Health inequities should be tackled in a preventive and proactive manner through the effective integration of intersectoral policies and strategies. This approach would enhance oral health, make patient safety a fundamental pillar of dental care, uphold human dignity, and strengthen trust in the healthcare system.
本研究旨在通过患者的声音，了解导致口腔医疗保健不平等和不公平的因素及其对患者安全的影响。采用扎根理论方法（GT）进行了一项定性研究，通过13次深入访谈，采用灵活的设计，为研究目的进行录音并逐字转录。生成了开放编码和轴心编码以及分析类别，并建立了一个概念性和解释性框架。获得了伦理批准。主要研究结果突出了个体、社会和环境因素如何显著影响口腔医疗保健中风险和失误的形成，最终影响牙科实践中的患者安全。这些因素包括个体因素、专业人员与患者之间的关系以及医疗服务提供中的失误。参与者的论述展示了不平等的例子，如性别、社会经济梯度、教育水平、医疗保健系统类型、歧视、污名化和他者化，以及它们对牙科护理和牙科安全的影响。应通过有效整合部门间政策和战略，以预防和积极主动的方式解决健康不平等问题。这种方法将改善口腔健康，使患者安全成为牙科护理的基本支柱，维护人的尊严，并增强对医疗保健系统的信任。
