Lewis D W, Thompson G W
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Am J Public Health. 1995 Oct;85(10):1408-11. doi: 10.2105/ajph.85.10.1408.
Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined.
Two birth cohorts 65 to 69 years old at entry who used the plan from 1978 to 1979 (n = 17,816) or from 1985 to 1986 (n = 27,474) were analyzed over 6 successive years for differences in dental services use and costs.
The 1985/86 cohort received 24% more visits per patient than the 1978/79 cohort. Their inflation-adjusted expenditures increased by 19% mainly as a result of increases in denturists' expenditures (33%) (dentists' expenditures increased just 4% because of lower plan fee increases). The 1985/86 cohort received relatively many more periodontal and fewer denture services. Annual attendance over 6 consecutive years was high, especially for the 1985/86 cohort and dentists' patients; 55% of the 1985/86 cohort who used dentists did so in 5 or all 6 years.
Differences in plan expenditures per patient between the birth cohorts and dentists and denturists, along with the high continuity of care for dentists' patients, have important implications for planning and administering dental plans for the elderly. The large expenditure decreases for removable dentures and the large increases for periodontal services to the 1985/86 cohort are noteworthy.
对加拿大艾伯塔省老年人全民牙科计划下两个队列的牙科服务使用情况进行了研究。
对两个在加入计划时年龄为65至69岁的出生队列进行了分析,这两个队列分别在1978年至1979年(n = 17,816)或1985年至1986年(n = 27,474)使用该计划,连续6年分析其牙科服务使用情况和成本差异。
1985/86队列每位患者的就诊次数比1978/79队列多24%。他们经通胀调整后的支出增加了19%,主要是由于假牙师支出增加(33%)(牙医支出仅增加4%,因为计划费用增幅较低)。1985/86队列接受的牙周服务相对较多,假牙服务相对较少。连续6年的年就诊率都很高,尤其是1985/86队列和牙医的患者;1985/86队列中使用牙医服务的患者有55%在5年或全部6年中都接受了治疗。
出生队列之间以及牙医和假牙师之间每位患者的计划支出差异,加上牙医患者护理的高连续性,对老年人牙科计划的规划和管理具有重要意义。1985/86队列可摘假牙支出大幅减少以及牙周服务大幅增加值得关注。