Challenges connecting emergency department patients with oral health care: A qualitative analysis of patients, emergency department clinicians, and dentists.
Challenges connecting emergency department patients with oral health care: A qualitative analysis of patients, emergency department clinicians, and dentists.
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DOI：
10.1016/j.adaj.2023.09.020
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发表时间：
2023-12-01
期刊：
影响因子：
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通讯作者：
Samuels-Kalow, Margaret
中科院分区：
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作者：
Simon, Lisa;Cardenas, Vanessa;Samuels-Kalow, Margaret
背景技术背景：未满足的牙科需求与未满足的健康相关社会需求（HRSN）（如住房和食品安全）有许多共同的风险因素，并且是在急诊科（艾德）寻求治疗的常见原因。作者招募了一个有目的的英语和西班牙语患者样本，3个城市ED的艾德临床医生，和附近社区的牙医参加定性访谈，以探讨在ED中筛选HRSN和未满足的牙科需求的障碍和促进因素。结果：访谈对象包括25名艾德患者、19名艾德临床医生和4名牙医。确定了四个主题：（1）偏好正规化资源，HRSN比口腔健康更常见;（2）经常使用不太可靠或结构化的临时资源，特别是牙科转诊信息;（3）社区口腔保健资源知识有限;（4）希望获得更多帮助，以确定和解决HRSN和口腔健康的资源需求。患者愿意通过各种方式进行筛查，并认为这将是有帮助的，但临床医生强调需要更容易的转诊过程，因为经常失败的连接患者到口腔healthcare.CONCLUSIONS：更强大的基础设施和临床医生的支持是必要的，以确保成功的转诊和筛查没有不必要的供应商负担的医疗和牙科临床医生。患者愿意在艾德接受未满足的口腔健康需求和HRSN筛查，这可能会改善获得护理的机会。
BACKGROUND: Unmet dental need shares many risk factors with unmet health-related social needs (HRSN) such as housing and food security and are a common cause for seeking treatment at the emergency department (ED).METHODS: The authors recruited a purposive sample of English-speaking and Spanish-speaking patients, ED clinicians at 3 urban EDs, and dentists from nearby communities to participate in qualitative interviews to explore barriers to and facilitators of screening for HRSN and unmet dental needs in the ED. Themes were identified from transcripts using a modified grounded theory approach.RESULTS: Interviews were conducted with 25 ED patients, 19 ED clinicians, and 4 dentists. Four themes were identified: (1) a preference for formalized resources, which more frequently exist for HRSN than for oral health; (2) frequent use of ad hoc resources that are less reliable or structured, particularly for dental referral information; (3) limited knowledge of oral health care resources in the community; and (4) desire for more assistance with identifying and addressing resource needs for both HRSN and oral health. Patients were amenable to screening through a variety of modalities and felt it would be helpful, but clinicians emphasized the need for easier referral processes because of frequent failure to connect patients to oral health care.CONCLUSIONS: More robust infrastructure and clinician support are needed to ensure successful referral and screening without undue provider burden for both medical and dental clinicians.PRACTICAL IMPLICATIONS: Patients are amenable to screening for unmet oral health needs and HRSN in the ED, which may improve access to care.