Holst D, Schuller A, Grytten J
Institute of Community Dentistry, University of Oslo, Norway.
Community Dent Oral Epidemiol. 1997 Feb;25(1):113-8. doi: 10.1111/j.1600-0528.1997.tb00907.x.
Future treatment needs for dental services are discussed in the perspective of the objective which the services are meant to fulfill. These are, broadly speaking, equal distribution of services and economic efficiency. Within the Nordic countries, the emphasis has been on equity, perhaps less on efficiency. Equity of utilization is best understood as being a situation where patients with equal needs for oral health care receive equal treatment, in terms of both the volume and the quality of the services. The justification for arguing that equality of utilization is the appropriate measure is mainly based on the externality argument: health-care consumption by one person may be the source of utility to another person. According to that view there are two beneficiaries of dental care: the patient who is sick, and the rest of society who care for the sick patient and who derive utility from seeing the patient become healthy. The public dental services for children in the Nordic countries are organized according to the principle of equity of utilization. Equity of access is best understood as being a situation where people with equal needs have equal opportunity to use dental services. It is a supply-side phenomenon; equal access is achieved when patients with the same needs face the same costs of dental-care consumption in terms of both time and money. The oral health situation among children, adults and the elderly is exemplified by national service data and recent studies.
从牙科服务旨在实现的目标角度讨论了其未来的治疗需求。大体而言，这些目标是服务的平等分配和经济效率。在北欧国家，重点一直放在公平上，对效率的关注可能较少。利用公平最好理解为这样一种情况：对口腔保健有同等需求的患者在服务的数量和质量方面都能得到平等的治疗。认为利用平等是适当衡量标准的理由主要基于外部性论点：一个人的医疗保健消费可能是另一个人的效用来源。根据这种观点，牙科护理有两个受益者：患病的患者，以及关心患病患者并从看到患者康复中获得效用的社会其他成员。北欧国家为儿童提供的公共牙科服务是根据利用公平原则组织的。获得公平最好理解为有同等需求的人有平等机会使用牙科服务的情况。这是一种供应方现象；当有相同需求的患者在时间和金钱方面面临相同的牙科护理消费成本时，就实现了平等获得。国家服务数据和近期研究举例说明了儿童、成年人和老年人的口腔健康状况。
