质量衡量儿童遵守和口腔健康结果
Sung Eun Choi1, Ankur Pandya2, Joel White3
1Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts.
JAMA network open
|January 30, 2024
概括
坚持牙科质量措施,如化物和密封剂,显著降低了儿童牙的风险. 这些预防性牙科护理福利对于高危儿童和有公共保险的儿童来说更为明显.
科学领域:
- 牙科公共卫生 牙科公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 基于过程的牙科质量措施旨在通过促进基于证据的实践来改善患者的结果.
- 牙科诊断代码的标准化历来挑战了过程测量和口腔健康结果之间的关联的评估.
研究的目的:
- 估计遵守牙科质量措施与患者口腔健康结果之间的关联.
- 调查接收局部化物和牙密封剂对儿童发展牙的风险的影响.
主要方法:
- 一个回顾性队列研究,使用目标试验仿真和因果推理框架.
- 分析了2014-2020年美国儿童和青少年 (0-18岁) 的电子健康记录.
- 采用粗精确匹配和时间到事件回归模型来调整混因子和估计危险比率.
主要成果:
- 遵守牙科质量措施与牙腐烂风险降低有关 (化物HR=0.82,密封剂HR=0.86).
- 与商业保险相比,患脏风险较高的儿童和拥有公共保险的儿童的福利更大.
- 这项研究包括69,212名美国儿童,分析时间为2023年5月至8月.
结论:
- 遵守牙科质量措施与儿童牙腐烂发病率较低有关.
- 针对性地实施质量改进举措可能会为高风险人群和拥有公共保险的人群带来更多的好处.
- 研究结果支持制定量身定制的策略,以优化牙科质量指标,以改善儿科口腔健康结果.
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