Unmet dental care needs among children with special health care needs: Implications for the medical home
Unmet dental care needs among children with special health care needs: Implications for the medical home
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DOI：
10.1542/peds.2005-0390
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发表时间：
2005-09-01
期刊：
影响因子：
8
通讯作者：
Phelps, S
中科院分区：
文献类型：
--
作者：
Lewis, C;Robertson, AS;Phelps, S
背景很少有人知道有特殊医疗保健需要的儿童（CSHCN）谁有未满足的牙科保健需求的特点。我们试图描述CSHCN中未满足的牙齿护理需求的程度，并描述那些未满足牙齿护理需求的人的特征。我们使用的数据来自全国有特殊卫生保健需求的儿童调查，该调查使用电话调查确定了来自50个州和哥伦比亚特区的750名CSHCN。对38 866个CSHCN家庭进行了调查，并对调查数据进行加权处理，以代表全国932万CSHCN。我们主要关注的结果是未满足的牙齿护理需求，定义为是否CSHCN被认为需要牙齿护理，但无法获得it.We还考虑了为什么一个孩子有一个未满足的牙齿护理需求的原因，并比较其他类别的医疗保健服务需求和未满足的需求与牙齿护理。进行双变量和多变量分析以确定与未满足的牙科保健需求相关的因素。总体而言，78%的CSHCN在过去12个月内需要牙科护理，这在需要频率方面仅次于处方药。在那些报告有牙齿护理需求的人中，估计有755581人或10.4%的CSHCN没有得到他们所需要的所有牙齿护理。相对于所有其他医疗保健服务类别，未满足的牙科保健需求影响最多的儿童。在多变量分析中，贫困儿童、未投保儿童、保险失效儿童和因残疾而受到更大限制的儿童的牙科保健需求未得到满足的几率显著更大。有私人医生或护士的儿童不太可能有未满足的牙科保健需求。牙科护理是CSHCN最普遍的未满足的医疗保健需求，比任何其他医疗保健需求类别影响更多的儿童。此外，CSHCN对牙科护理的需求超过了预防或专业医疗护理的需求。鉴于这些发现，牙科护理应该是医疗之家旨在为CSHCN提供的全面协调服务的一个组成部分，并明确说明。需要作出更大努力，改善贫困和更多残疾CSHCN获得牙科保健的机会。
Background. Little is known about the characteristics of children with special health care needs ( CSHCN) who have unmet dental care needs.Objective. We sought to describe the magnitude of unmet needs for dental care among CSHCN and to characterize those with unmet dental care needs.Design, Setting, and Subjects. We used data from the National Survey of Children with Special Health Care Needs, which used a telephone survey to identify 750 CSHCN from each of the 50 states and the District of Columbia. Families of 38 866 CSHCN were interviewed, and the data were weighted to represent 9.32 million CSHCN nationally.Outcome. Our primary outcome of interest was unmet dental care need, defined as whether CSHCN were said to have needed dental care but were unable to obtain it. We also considered reasons why a child had an unmet dental care need and compared other categories of health care service needs and unmet needs with dental care. Bivariate and multivariate analyses were conducted to determine factors associated with unmet dental care needs.Results. Overall, 78% of CSHCN were reported as needing dental care in the past 12 months, which was second only to prescription medications in the frequency of need. Of those who reported a dental care need, an estimated 755 581 or 10.4% of CSHCN did not receive all of the dental care they needed. Relative to all other health care service categories, unmet dental care needs affected the most children. Poorer children, uninsured children, children with lapses in insurance, and children with greater limitations attributable to disability had significantly greater odds of unmet dental care needs in multivariate analyses. Children with a personal doctor or nurse were significantly less likely to have unmet dental care needs.Conclusions. Dental care is the most prevalent unmet health care need for CSHCN, affecting substantially more children than any other health care need category. Moreover, the perceived need for dental care for CSHCN exceeds the need for either preventive or specialty medical care. Given these findings, dental care should be an integral and explicitly stated part of the comprehensive coordinated services that the medical home aims to provide for CSHCN. Greater efforts to improve access to dental care for poor and more disabled CSHCN are needed.