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儿科初级保健中的多层次干预和牙科护理:一个集群随机临床试验
Suchitra Nelson1,2, Jeffrey M Albert2, David Selvaraj1
1Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio.
JAMA network open
|July 9, 2024
概括
多层次干预改善了牙医的出席率,并减少了幼儿未经治疗的. 儿科临床医生将口腔健康纳入健康儿童诊所 (WCVs) 显示出更好的结果.
科学领域:
- 儿科牙科 儿科牙科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 未经治疗的牙腐烂不成比例地影响低收入的幼儿.
- 儿科指南建议将口腔保健整合起来,但有效性尚不清楚.
研究的目的:
- 评估多层次的干预措施,以增加牙医出勤率,减少学龄前儿童未经治疗的.
- 评估综合口腔卫生服务在健康儿童诊所 (WCVs) 期间的影响.
主要方法:
- 在俄俄州的18个儿科诊所进行集群随机临床试验.
- 干预包括实践层面 (EMR变化) 和临床医生层面 (教育,技能培训) 的组成部分.
- 对照组接受了标准的口腔健康教育;通过牙科检查和索赔数据来衡量结果.
主要成果:
- 根据临床检查 (P=.02) 的数据,干预组 (52.0%) 与对照组 (43.1%) 的牙医出诊率显著增加 (P=.02).
- 医疗补助申请显示,2年后对照组的出席率更高,但不是3年.
- 在干预组中观察到未经治疗的的临床上有意义的,但不具有统计学意义的减少.
结论:
- 多层次干预有效地增加了初级保健机构中幼儿的牙医出诊率.
- 儿科临床医生全面将口腔卫生服务纳入WCV,从而改善了牙科的结果.
- 研究结果支持在儿科初级保健中更广泛地实施综合口腔健康战略.
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