Bridging the dental-medical divide Case studies integrating oral health care and primary health care
Bridging the dental-medical divide Case studies integrating oral health care and primary health care
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DOI：
10.1016/j.adaj.2018.05.030
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发表时间：
2018-10-01
影响因子：
3.9
通讯作者：
Rozier, R. Gary
中科院分区：
文献类型：
--
作者：
Atchison, Kathryn A.;Weintraub, Jane A.;Rozier, R. Gary
背景美国国家科学院、工程院和医学院委托进行了一项环境扫描，描述了口腔健康和初级保健服务的卫生保健整合状况。作者对2000年1月至2017年8月的美国一体化活动进行了环境扫描。他们将服务分类为由医疗保健提供者提供的预防性口腔健康服务（POHS），由牙科提供者在非牙科环境中提供的POHS，由牙科提供者提供的预防性健康服务，或使用专门人员和技术的护理协调。作者选择了四个项目作为案例研究，并采访了每个项目的关键人员。一个案例研究说明了每个类别的综合服务，其他例子描述类别的变化。案例研究涉及进入婴儿的嘴说明医疗专业人员提供POHS儿童。涉及格雷斯健康的案例研究介绍了嵌入在妇产科诊所的牙科医生，为孕妇提供口腔筛查，预防和教育。在HealthPartners，医疗保健提供者将糖尿病患者转介给牙医，并免除牙周护理的共同负担费用。社区间健康网络协调医疗组织使用专门的患者协调员，技术，协调支付和转诊机制，以促进护理。牙科和医疗保健的整合增加了获得和协调病人护理的手段，提供传统上由其他专业提供的医疗保健服务。整合模式展示了初级保健专业人员将POHS纳入，将牙科专业人员嵌入初级保健诊所，以及纳入护理协调以增加口腔保健的提供。同样，牙医也会识别有医疗需求或预防缺口的患者，并将其转介到医疗之家。
Background. The National Academies of Sciences, Engineering, and Medicine commissioned an environmental scan describing the status of health care integration of oral health and primary care services.Methods. The authors conducted an environmental scan of US integration activities with publications from January 2000 through August 2017. They categorized services as preventive oral health services (POHS) provided by medical care providers, POHS provided by dental providers in nondental settings, preventive health services provided by dental providers, or care coordination using dedicated personnel and technology. The authors chose 4 programs as case studies and interviewed key personnel in each program. One case study illustrates each category of integrated services; additional examples describe category variation.Results. The case study involving Into the Mouth of Babes illustrates medical professionals delivering POHS to children. The case study involving Grace Health presents dental hygienists embedded in the obstetrics-gynecology clinic to provide oral screening, prophylaxis, and education to pregnant women. At HealthPartners, medical care providers refer patients with diabetes to dentists and waive copays for periodontal care. The InterCommunity Health Network Coordinated Care Organization uses dedicated patient coordinators, technology, and coordinated payment and referral mechanisms to facilitate care.Conclusions. Integration of dental and medical care increased access to and coordination of patient care by means of offering health care services traditionally provided by the other profession.Practical Implications. Integration models demonstrate the incorporation of POHS by primary care professionals, the embedding of dental professionals into primary care clinics, and the incorporation of care coordination to increase the delivery of oral health care. Similarly, dentists identify and refer patients with medical needs or preventive gaps to medical homes.