Patient Visits to Physician Offices and/or Emergency Rooms for Dental Problems

描述(由申请者提供)：项目摘要：本项目的总体目标是研究低收入少数族裔成年人在治疗牙科问题时到医生办公室和/或医院急诊科就诊的情况及其相互关系。理由：穷人和少数族裔成年人患牙病的水平更高，而且经常面临费用和其他系统层面的障碍，无法获得私人牙科诊所。因此，这些人可能会选择在替代治疗地点接受治疗，特别是医生办公室和急诊室。然而，由于非牙医很少接受牙科问题管理方面的培训，这些地点可能不是寻求彻底缓解牙科问题的个人接受治疗的最合适地点。具体目标是：1.确定低收入的非西班牙裔白人、非西班牙裔非裔美国人和西班牙裔成年人与收入较高的人相比，在前6个月期间使用医生办公室和/或急诊室治疗牙齿问题的频率；2.确定预测使用医生办公室和/或急诊室治疗牙齿问题的易感、使能和基于需求的因素；3.确定在医生办公室和急诊室接受的治疗的性质；4.确定所接受治疗的适当性和质量；5.确定患者对所接受治疗的满意度：研究设计：研究小组将使用焦点小组、认知访谈和经济有效的电话调查方法相结合的方法来确定、联系和确保低收入非西班牙裔白人、非西班牙裔非裔美国人和西班牙裔成年人的反应(将收集高收入个人的数据以供比较)。重点小组和认知访谈将有助于开发具有文化敏感度和相关性的电话调查工具。相关性：对于决定使用医生办公室和急诊室治疗牙科问题的低收入/少数群体而言，有文化上相关的诱因、促成因素和基于需求的因素。如果决策者要制定政策和规划方案，解决影响低收入/少数群体卫生服务利用的独特社会和文化条件，就必须更全面地了解这些因素。随着人口老龄化，这些问题将变得越来越重要，因为老年人通常更有可能去看医生，而不是牙医。

DESCRIPTION (provided by applicant): Project Summary: The Broad Objective of this project is to examine the use and correlates of patient visits to physician offices and/or hospital emergency departments (EDs) for the treatment of dental problems by low-income minority adults. Rationale: Poor and minority adults experience greater levels of dental disease and frequently face cost and other system-level barriers to accessing private dental practice. Therefore, these individuals may choose to receive care at alternative treatment sites, especially physician offices and EDs. However, since non-dentists receive little training in the management of dental problems, these sites may not be the most appropriate sites to receive treatment for individuals seeking definitive relief from dental problems. Specific Aims are to: 1. Determine frequency at which low-income non-Hispanic White, non-Hispanic African-American, and Hispanic adults as compared to higher income individuals utilized physician offices and/or EDs for the treatment of dental problems during the prior 6-month period; 2. Determine predisposing, enabling, and need-based factors that predict the use of physician offices and/or EDs for the treatment of dental problems; 3..Determine nature of treatment received in physician offices and EDs; 4. Determine appropriateness and quality of the treatment received; and 5. Determine patient satisfaction with the treatment received: Research Design: The research team will use a combination of focus group, cognitive interview, and cost-effective telephone survey methodologies to identify, contact, and secure responses from low-income non-Hispanic White, non-Hispanic African-American, and Hispanic adults (data on higher income individuals will be collected for comparative purposes). The focus groups and cognitive interviews will facilitate the development of a culturally sensitive and relevant telephone survey instrument. Relevance: There are culturally related predisposing, enabling, and need-based factors, specific to low- income/minority populations that contribute to the decision to use physician offices and EDs for the treatment of dental problems. These factors must be understood more completely if decision makers are to develop polices and plan programs that address the unique social and cultural conditions that affect utilization of health services among low income/minority populations. These issues will grow in importance with the aging of the population, as elderly individuals, in general, are more likely to visit a physician than a dentist.