Meeting the oral health needs of 12-year-olds in China: human resources for oral health.
Meeting the oral health needs of 12-year-olds in China: human resources for oral health.
复制标题
DOI：
10.1186/s12889-017-4384-7
复制
发表时间：
2017-06-20
影响因子：
4.5
通讯作者：
Gallagher JE
中科院分区：
文献类型：
--
作者：
Sun X;Bernabé E;Liu X;Zheng S;Gallagher JE
需要适当水平的口腔健康人力资源，以满足人口的口腔健康需求，并最大限度地改善健康结果。本研究的目的是估计中国12岁儿童口腔健康所需的HROH，并考虑其对全国教育、实践、政策和HROH的影响。我们根据第三次全国口腔健康调查的流行病学和问卷调查数据，包括龋齿经历和牙周因素(牙石)、与牙齿相关的行为(刷牙和吃糖的频率)和社会因素(父母教育)，估计了HROH满足12岁儿童需求的需要。儿童患龋齿的风险从低(1级)到高(4级)分为四个级别。根据当代循证实践，我们建立了针对每个风险水平的最大和最小牙科护理干预模型。我们在本研究中使用的需求导向的HROH模型包含了治疗需求和基于风险的预防，使用中国专家验证的时间安排。这些发现被用来估计调查样本的HROH，推算到全国12岁儿童和总人口，考虑到城市和农村的覆盖，基于不同的临床承诺水平(60%-90%)。我们发现，根据80%的临床承诺，全国范围内需要40,139至51,906名牙科专业人员为12岁的儿童提供护理。我们发现，农村人口对HROH的需求最大(72.5%)。在模型中，超过93%的HROH时间致力于预防。将结果外推到总人口，全国范围内实现全国覆盖的HROH估计为316-409万；然而，根据HROH将90%的时间花在提供临床护理上，目前HROH只能以最低限度的干预为大约5%的人口提供服务。这一发现突显了中国牙科劳动力需求和劳动力能力之间的差距。随着卫生系统的发展，讨论了口腔卫生对卫生政策和人力资源的重大影响，包括采取公共卫生行动的必要性。本文的在线版本(doi：10.1186/s12889-0174384-7)包含补充材料，授权用户可以使用。
An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education). Children’s risk for dental caries was classified in four levels from low (level 1) to high (level 4). We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%). We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%). Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16–4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with minimum intervention based on a HROH spending 90% of their time in providing clinical care. The findings highlight the gap between dental workforce needs and workforce capacity in China. Significant implications for health policy and human resources for oral health in this country with a developing health system are discussed including the need for public health action. The online version of this article (doi:10.1186/s12889-017-4384-7) contains supplementary material, which is available to authorized users.