WorldWideScience

Sample records for dental care access

  1. Dental visits and access to dental care among Maryland schoolchildren.

    Science.gov (United States)

    Macek, Mark D; Wagner, Mark L; Goodman, Harold S; Manz, Michael C; Marrazzo, Ilise D

    2005-04-01

    Regular dental visits afford an opportunity for dentists to provide preventive services and to diagnose and treat disease. Not all children, however, have equal access to these services. The authors conducted this study to describe access to and utilization of oral health care services for Maryland schoolchildren in kindergarten and third grade. They obtained data from a questionnaire filled out by parents or guardians participating in the Survey of the Oral Health Status of Maryland School Children, 2000-2001 (N = 2,642). Outcome variables included having a dental visit in the last year, prophylaxis in the last year, usual source of medical care and usual source of dental care. Descriptor variables included region, grade, race/ethnicity, eligibility for free or reduced-fee meals, parents' or guardians' education and dental insurance status. Overall, general dental visit and dental prophylaxis visit rates were similar (74.1 and 71.3 percent, respectively). Schoolchildren, however, were more likely to have had a usual source of medical care than of dental care (96.0 and 82.9 percent, respectively). Third graders, those ineligible for free or reduced-fee meals and those with some dental insurance coverage were more likely to have received a prophylaxis in the last year and were more likely to have a usual source of dental care. Non-Hispanic white and non-Hispanic black schoolchildren also were more likely to have had a usual source of dental care than were Hispanics. Schoolchildren most likely to have received regular preventive dental care were those who had parents or guardians with financial resources. Medicaid and State Children's Health Insurance Program (SCHIP) provide safety nets, but these programs could be improved. Dentistry's challenge is to determine which characteristics are unique to those who visit the dentist regularly and use this information to help meet the needs of the underserved.

  2. Disparities in children's oral health and access to dental care.

    Science.gov (United States)

    Mouradian, W E; Wehr, E; Crall, J J

    Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.

  3. Expanding dental hygiene to include dental therapy: improving access to care for children.

    Science.gov (United States)

    Nash, David A

    2009-01-01

    Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health contributed significantly to raising the awareness of the American public and the dental profession regarding the lack of access to oral health care by many Americans, especially minorities and low income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current workforce of dentists in the United States is inadequate to meet the oral health care needs of children in terms of numbers of dentists, as well as their distribution, ethnicity, education, and practice orientation. Dental hygienists trained in an expanded scope of practice, can help address the workforce inadequacy. Dental therapists, educated in 2-year programs of postsecondary education, comparable to America's associate degree dental hygiene programs, have been used throughout the world to provide basic, primary oral health care for children. Research has documented that utilizing dental therapists is a cost effective method of improving access to care for children. Countries that have led the way in introducing dental therapists to care for their children are now integrating their separate 2-year curriculum in dental therapy and dental hygiene into a 3-year curriculum to prepare a clinician dually trained in both dental therapy and dental hygiene. This clinician is being designated an oral health therapist. Expanding the education of dental hygienists in the United States to include skills of the internationally acclaimed dental therapist can produce oral health therapists, individuals capable of addressing the basic preventive, restorative, and minor surgical needs of children, but also able to continue to address the preventive and periodontal needs of adults.

  4. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    LENUS (Irish Health Repository)

    Prabhu, Neeta T

    2010-03-01

    The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  5. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    Science.gov (United States)

    Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M

    2010-01-01

    The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  6. A national analysis of dental waiting lists and point-in-time geographic access to subsidised dental care: can geographic access be improved by offering public dental care through private dental clinics?

    Science.gov (United States)

    Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

    2017-01-01

    Australia is one of the least densely populated countries in the world, with a population concentrated on or around coastal areas. Up to 33% of the Australian population are likely to have untreated dental decay, while people with inadequate dentition (fewer than 21 teeth) account for up to 34% of Australian adults. Historically, inadequate access to public dental care has resulted in long waiting lists, received much media coverage and been the subject of a new federal and state initiative. The objective of this research was to gauge the potential for reducing the national dental waiting list through geographical advantage, which could arise from subcontracting the delivery of subsidised dental care to the existing network of private dental clinics across Australia. Eligible population data were collected from the Australian Bureau of Statistics website. Waiting list data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual state or territory dental health body. Quantum geographic information system software was used to map distribution of the eligible population across Australia by statistical area, and to plot locations of government and private dental clinics. Catchment areas of 5 km for metropolitan clinics and 5 km and 50 km for rural clinics were defined. The number of people on the waiting list and those eligible for subsidised dental care covered by each of the catchment areas was calculated. Percentage of the eligible population and those on the waiting list that could benefit from the potential improvement in geographic access was ascertained for metropolitan and rural residents. Fifty three percent of people on the waiting list resided within metropolitan areas. Rural and remote residents made up 47% of the population waiting to receive care. The utilisation of both government and private dental clinics for the delivery of subsidised dental care to the eligible population

  7. Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents

    Science.gov (United States)

    Gerreth, Karolina; Borysewicz-Lewicka, Maria

    2016-01-01

    Background: A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of…

  8. Adding dental therapists to the health care team to improve access to oral health care for children.

    Science.gov (United States)

    Nash, David A

    2009-01-01

    Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health, contributed significantly to raising awareness regarding the lack of access to oral health care by many Americans, especially minority and low-income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current dental workforce in the United States is inadequate to meet the oral health care needs of children. It is inadequate in terms of numbers of dentists, as well as their geographic distribution, ethnicity, education, and practice orientation. Dental therapists, paraprofessionals trained in a 2 academic-year program of postsecondary education, have been employed internationally to improve access to oral health care for children. Research has documented that utilizing dental therapists is a cost-effective method of providing quality oral health care for children. Dental therapists have recently been introduced in Alaska by the Alaska Native Tribal Health Consortium. Dental therapists could potentially care for children in dental offices, public health clinics, and school systems, as well as in the offices of pediatricians and family physicians. Adding dental therapists to the health care team would be a significant strategy for improving access to care for children and reducing oral health disparities.

  9. Perceived barriers in accessing dental care among patients attending dental institute using decision-making trial and evaluation laboratory method

    Directory of Open Access Journals (Sweden)

    Ravneet Malhi

    2015-01-01

    Full Text Available Introduction: Utilization of dental service is a concept of expressing the extent of interaction between the service provider and the people for whom it is indented. However, one of the major issues in social welfare is the equitable provision of these services to the population. Aim: To determine the perceived barriers affecting access to the dental services in the dental institute. Materials and Methods: A cross-sectional survey was conducted in the dental institute during the month of February in the year 2014 using decision-making trial and evaluation laboratory (DEMATEL method. The study sample included the 364 subjects. The required data were collected using a specially designed and pretested questionnaire. The data were analyzed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA and MATLAB 7.6.0. The mean, standard deviations were used to describe the data, and inferential statistics included one-way ANOVA and DEMATEL. Results: The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access dental services. Based on subjects′ responses to the questions, the cost (54.75% agreed or strongly agreed was identified as the most important factor affecting the access to dental health care followed by dentist-patient relationship (48.57%, inconvenience (36.55%, fear (23.70%, and organization (14.02%. The difference was found to be statistically significant (P = 0.0001. When the hierarchy of the affecting and affected factors was calculated, based on the factor analysis by using DEMATEL method, the cost (R−J = 0.16 and organization (R−J = 1.15, were certain affecting determinant which influenced the access to dental services and inconvenience. Conclusion: The major barriers to oral health care utilization among our patients were cost, fear, and organization. Policymakers, administrators, and insurance organizations have a major role. Hence, the policies should be fair and

  10. Access to dental care for HIV patients: does it matter and does discrimination exist?

    Science.gov (United States)

    Levett, T; Slide, C; Mallick, F; Lau, R

    2009-11-01

    A number of surveys highlight a shortage of dentists in the UK. There is also evidence of discrimination against those with HIV reported within the dental profession and service users. We decided to assess the extent of this problem in our HIV outpatients by conducting a cross-sectional survey, asking them to complete a questionnaire exploring issues related to dental care access, and using clients attending the routine genitourinary (GU) medicine outpatient clinic as controls. A total of 241 outpatients completed the survey, of whom 51 (21%) were HIV patients. Significantly, more HIV patients reported difficulty registering with a dentist than GU patients (58.8% versus 18.2%, chi(2) with Yates correction = 8.76, P = 0.0031). They also report significantly more dental health problems compared with controls (54.9% versus 32.1%, chi(2) with Yates correction = 8.02, P = 0.0046). In total, 34.6% of HIV patients who had declared their status to a dentist thought that it had negatively impacted on their care, with 6.2% being refused treatment. Our small survey confirms that discrimination in relation to access and level of dental care exists, with black African women being at most risk. Efforts are needed to raise professional standards and HIV awareness to prevent continuing inequalities in dental care provision.

  11. Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia.

    Science.gov (United States)

    Happell, Brenda; Platania-Phung, Chris; Scott, David; Hanley, Christine

    2015-01-01

    People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n=643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers.

  12. Access to Dental Care for Rural Children: A Survey of Nebraska General Dentists

    Science.gov (United States)

    McFarland, Kimberly K.; Salama, Fouad; Yaseen, Muhammad

    2011-01-01

    Background: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. Purpose: The objectives of the study were to establish a baseline in regard to the quantity of pediatric…

  13. Access to Dental Care for Rural Children: A Survey of Nebraska General Dentists

    Science.gov (United States)

    McFarland, Kimberly K.; Salama, Fouad; Yaseen, Muhammad

    2011-01-01

    Background: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. Purpose: The objectives of the study were to establish a baseline in regard to the quantity of pediatric…

  14. Availability of dental treatment is associated with satisfaction derived from Primary Health Care Services accessed by elderly

    Directory of Open Access Journals (Sweden)

    Aline Blaya MARTINS

    Full Text Available Abstract Objective This research evaluated whether having dental treatment available in the primary health care centers of the Brazilian Unified Health System was associated with greater satisfaction with the services accessed. The offering of dental care within the health service that elders usually access may improve their satisfaction with the services as a whole. Material and method In this cross-sectional study, 401 elders living in the districts of Lomba do Pinheiro and Partenon in Porto Alegre, Brazil were interviewed. Elders were selected using a cluster sampling design process from census tract drawings. Result Poisson Regression revealed that age and dental treatment supply were associated with outcome, and age, number of teeth, and the presence of dental treatment were associated with a higher prevalence of satisfaction with health services. Conclusion These results provide new contributions for health system qualification because this study demonstrated the importance of having dental treatment available to improve the satisfaction of older people with the Primary Health Care (PHC services accessed.

  15. Update on disparities in oral health and access to dental care for America's children.

    Science.gov (United States)

    Edelstein, Burton L; Chinn, Courtney H

    2009-01-01

    This contribution updates federal survey findings on children's oral health and dental care since release of Oral Health in America: A Report of the Surgeon General in 2000. Dental caries experience continued at high levels, impacting 40% of all children aged 2 to 11 years, with greater disease and untreated disease burden borne by poor and low-income children and racial/ethnic minorities. Caries rates increased for young children (to 28% of 2- to 5-year-olds in the period 1999-2004) and remained flat for most other ages. The total volume of caries and untreated caries increased as the numbers of children increased. The proportion of US children with a dental visit increased modestly (from 42% to 45% between 1996 and 2004), with the greatest increases occurring among children newly covered by the State Children's Health Insurance Program (SCHIP). Disparities in dental visits continued to be evidenced by age, family income, race/ethnicity, and caregiver education. Parental reports of children's oral health and dental care parallel these findings and also reveal higher unmet dental needs among children with special health care needs. Racial- and income-based disparities in both oral health and dental care continue into adolescence and young adulthood. These disparities can, as in the past, be expected to exacerbate under the forces of growing income disparities and demographic trends.

  16. Access to dental care in two long-term refugee camps in western Tanzania; programme development and assessment.

    Science.gov (United States)

    Roucka, Toni M

    2011-04-01

      To analyse the demographics surrounding and the sustainability of a course in Emergency Dental Care and Health Promotion developed and taught by a team of dentists from the United States to refugee camp health-care workers in two long-term refugee camps in Western Tanzania.   Refugee camp dental patient log books from Mtabila and Nyarugusu camps Kigoma, Tanzania were analysed and demographic data collected on each patient visit from the programme inception in November 2007 until August 2009. Data collection included information relevant to 1961 patient visits. Data were entered into SPSS Statistics 17.0 using the Freq application.   Patient visit data included demographics involving both the resident camp populations and the surrounding communities. The distribution of patients treated by nationality was: 58% Burundian (Mtabila), 14% Congolese (Nyarugusu), and 28% Tanzanian citizens residing near both camps. Extractions accounted for 95.5% of procedures performed. Recorded incidences of post-operative complications were 1> % of patient visits. Patient visits were steady over time and a referral system was implemented for complex cases. Health promotion sessions were held in both camps.   This dental programme has been self-sustaining and is providing some access to care where none existed previously. Programmes such as this may be one solution to the access to dental care problem in long-term refugee camps. © 2011 FDI World Dental Federation.

  17. Dental Care in Pregnancy

    Science.gov (United States)

    Share with Women Dental Care in Pregnancy Why is dental care in pregnancy important? During pregnancy, you are more likely to have problems ... There are 2 major reasons women can have dental problems during pregnancy: Pregnancy gingivitis— During pregnancy, changes ...

  18. Medicaid Meets Its Equal Access Requirement For Dental Care, But Oral Health Disparities Remain.

    Science.gov (United States)

    Shariff, Jaffer A; Edelstein, Burton L

    2016-12-01

    Most US children today have public or private dental health insurance, yet oral health among publicly insured children remains a policy concern. We analyzed data for 2011-12 from the National Survey of Children's Health to compare oral health status and the use of dental care among publicly and privately insured children. After we adjusted for demographic and parent characteristics, we found no differences between the two groups in parent-reported use of dental care or unmet need for dental care. However, compared to parents of privately insured children, parents of publicly insured children were less likely to report that the condition of their child's teeth was excellent or very good and more likely to report that the child had had a dental problem in the past twelve months. Family income differences between the groups accounted for much of this disparity. Our findings suggest that Medicaid is meeting its mandate to ensure that dental care is as available for children in the program as it is for privately insured children, but refinements in Medicaid policy are needed to improve poor children's oral health. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Improving access to oral health care services among underserved populations in the U.S.: is there a role for mid-level dental providers?

    Science.gov (United States)

    Shaefer, H Luke; Miller, Matthew

    2011-08-01

    Nearly one-third of U.S. citizens lack access to basic preventive and primary oral health care services, which is primarily the result of the high costs of care and the uneven geographic distribution of dental providers. This article examines the case for and against one possible solution to address these barriers to oral health care: the introduction of a mid-level dental provider (MDP) position within the dental field.

  20. Public and private dental services in NSW: a geographic information system analysis of access to care for 7 million Australians.

    Science.gov (United States)

    Willie-Stephens, Jenny; Kruger, Estie; Tennant, Marc

    2014-06-01

    To investigate the distribution of public and private dental practices in NSW in relation to population distribution and socioeconomic status. Dental practices (public and private) were mapped and overlayed with Census data on Collection District population and Socio-Economic Indexes for Areas (SEIFA). Overall, there was an uneven geographic distribution of public and private dental practices across NSW. When the geographic distribution was compared to population socioeconomics it was found that in rural NSW, 12% of the most disadvantaged residents lived further than 50km from a public dental practice, compared to 0% of the least disadvantaged. In Sydney, 9% of the three most disadvantaged groups lived greater than 7.5km from a public dental practice, compared to 21% of the three least disadvantaged groups. The findings of this study can contribute to informing decisions to determine future areas for focus of dental resource development (infrastructure and workforce) and identifying subgroups in the population (who are geographically isolated from accessing care) where public health initiatives focused on amelioration of disease consequences should be a focus.

  1. Evidence summary: why is access to dental care for frail elderly people worse than for other groups?

    Science.gov (United States)

    Caines, Beth

    2010-02-13

    In August 2009, members of the newly redeveloped Primary Care Dentistry Research Forum (http://www.dentistryresearch.org) took part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question which received the most votes formed the subject of a critical appraisal of the relevant literature. Each month a new round of voting will take place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website.This paper details a summary of the findings of the first critical appraisal. In conclusion, the critical appraisal has identified that primary research is needed to look at the subject of access to dental care for frail elderly people. Similar barriers to accessing care for this group of people are still being reported today as they were 20 years ago.

  2. Dental Care for Medicaid and CHIP Enrollees

    Science.gov (United States)

    ... Close Home > Medicaid > Benefits > Dental Care Dental Care Dental Care Dental Care for Medicaid and CHIP Enrollees Dental health ... services and opportunities and challenges to obtaining care. Dental Benefits for Children in Medicaid Medicaid covers dental ...

  3. Dental Care in Scleroderma

    Science.gov (United States)

    Dental Care in Scleroderma People living with scleroderma face unique challenges while trying to maintain their oral ... They are more likely to be affected by dental conditions such as small mouth, dry mouth, jaw ...

  4. Dental care - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002213.htm Dental care - child To use the sharing features on ... and rinsing daily. It also includes having routine dental exams, and getting necessary treatments such as fluoride, ...

  5. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    Science.gov (United States)

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

  6. Improving access to dental care for vulnerable children; further development of the Back2School programme in 2013.

    Science.gov (United States)

    Simons, D; Pearson, N; Evans, P; Wallace, T; Eke, M; Wright, D

    2015-06-01

    This paper describes a service evaluation of a dental treatment programme providing care to children not normally taken to the dentist. It explains the extension of the Back2School programme from the pilot phase and assesses if a mobile dental unit (MDU) can provide a high quality service. The public health competencies it illustrates include oral health improvement, developing and monitoring quality dental services, and collaborative working.

  7. Access to Dental Care for Children in Rhode Island. Rhode Island Kids Count Issue Brief.

    Science.gov (United States)

    Katz, Linda; Fontes, Janice; Ross, Maureen; Lawrence, Robin; Andrews, John; Kernan, Sharon; Leddy, Tricia; O'Bara, Joan; Young, John

    Dental disease restricts activities in school, work, and home, and often significantly diminishes the quality of life for many children and adults, especially those who are low income or uninsured. Noting that dental caries (tooth decay) is the most common preventable chronic childhood disease, this Kids Count issue brief considers the extent to…

  8. IV access in dental practice.

    LENUS (Irish Health Repository)

    Fitzpatrick, J J

    2009-04-01

    Intravenous (IV) access is a valuable skill for dental practitioners in emergency situations and in IV sedation. However, many people feel some apprehension about performing this procedure. This article explains the basic principles behind IV access, and the relevant anatomy and physiology, as well as giving a step-by-step guide to placing an IV cannula.

  9. Utilization of dental care: An Indian outlook.

    Science.gov (United States)

    Gambhir, Ramandeep Singh; Brar, Prabhleen; Singh, Gurminder; Sofat, Anjali; Kakar, Heena

    2013-07-01

    Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities.

  10. Utilization of dental care: An Indian outlook

    Science.gov (United States)

    Gambhir, Ramandeep Singh; Brar, Prabhleen; Singh, Gurminder; Sofat, Anjali; Kakar, Heena

    2013-01-01

    Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities. PMID:24082719

  11. U.S. predoctoral education in pediatric dentistry: its impact on access to dental care.

    Science.gov (United States)

    Seale, N Sue; Casamassimo, Paul S

    2003-01-01

    This study sought to identify faculty, organization, patient pool, and procedures taught in predoctoral pediatric dentistry programs using a questionnaire sent to all fifty-five U.S. dental schools in 2001. Forty-eight (87 percent) programs reported an average of 3.9 full-time and 2.1 part-time FTE faculty, resulting in a mean faculty to student ratio of 1:6.4. One-third employ general dentists to teach pediatric dentistry, and 36 percent report fewer faculty than five years ago. Two-thirds were stand-alone departments. Over half (55 percent) reported increases in patient pools, but also a lack of patients with restorative needs. Half of the programs supplemented school-based pools with special populations, and two-thirds sent students on external rotations, most often to treat high-caries children. Those not using external rotations cited lack of faculty. Accepted patients averaged about four years, with only 6 percent of the pool under three years. Low-income or Medicaid-covered children accounted for 88 percent of school patient pools. Half of the schools felt the pool inadequate to meet competencies, attributable to lack of patients' restorative needs or inadequate intake numbers. Fewer than half of the programs (48 percent) provided hands-on experience with disabled patients, and one-third afforded every student with this experience. Pediatric dentistry was mentioned in fewer than half of the competency documents. Results suggest that U.S. pediatric dentistry predoctoral programs have faculty and patient pool limitations that affect competency achievement and adversely affect training and practice.

  12. Infant dental care (image)

    Science.gov (United States)

    ... sugar water. As the child grows, establishing proper dental hygiene will promote healthy teeth and gums which are essential to overall good health. Poor dental development, dental disease, and dental trauma can result ...

  13. Dental Care Utilization among North Carolina Rural Older Adults

    Science.gov (United States)

    Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

    2012-01-01

    Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

  14. [Oral health and access to dental care services in relation to the Health Necessities Index: São Paulo, Brazil, 2008].

    Science.gov (United States)

    Junqueira, Simone Rennó; Frias, Antônio Carlos; Zilbovicius, Celso; Araujo, Maria Ercilia de

    2012-04-01

    The Health Department of São Paulo, Brazil, has developed a Health Necessities Index (HNI) to identify priority areas for providing health assistance. In 2008, a survey of the status of oral health was conducted. The objective of this ecological study was to analyze the status of oral health in relation to the HNI. The variables, stratified by the age of 5, 12 and 15 years old were: percentage of individuals with difficulty of access to dental care services; DMFT and DMFS; prevalence of the need for tooth extraction and treatment of dental caries. Data were analyzed for the 25 Health Technical Supervision Units (HTS). The Statistical Covariance Test was used as well as the Pearson correlation coefficient and linear regression model. A positive correlation was observed between high scores of the HNI and difficulty of access to services. In the HTS with high scores of HNI a higher incidence of dental caries was observed, a greater need for tooth extractions and low caries-free incidence. In order to improve health conditions of the population it is mandatory to prioritize actions in areas of social deprivation.

  15. The language spoken at home and disparities in medical and dental health, access to care, and use of services in US children.

    Science.gov (United States)

    Flores, Glenn; Tomany-Korman, Sandra C

    2008-06-01

    Fifty-five million Americans speak a non-English primary language at home, but little is known about health disparities for children in non-English-primary-language households. Our study objective was to examine whether disparities in medical and dental health, access to care, and use of services exist for children in non-English-primary-language households. The National Survey of Childhood Health was a telephone survey in 2003-2004 of a nationwide sample of parents of 102 353 children 0 to 17 years old. Disparities in medical and oral health and health care were examined for children in a non-English-primary-language household compared with children in English- primary-language households, both in bivariate analyses and in multivariable analyses that adjusted for 8 covariates (child's age, race/ethnicity, and medical or dental insurance coverage, caregiver's highest educational attainment and employment status, number of children and adults in the household, and poverty status). Children in non-English-primary-language households were significantly more likely than children in English-primary-language households to be poor (42% vs 13%) and Latino or Asian/Pacific Islander. Significantly higher proportions of children in non-English-primary-language households were not in excellent/very good health (43% vs 12%), were overweight/at risk for overweight (48% vs 39%), had teeth in fair/poor condition (27% vs 7%), and were uninsured (27% vs 6%), sporadically insured (20% vs 10%), and lacked dental insurance (39% vs 20%). Children in non-English-primary-language households more often had no usual source of medical care (38% vs 13%), made no medical (27% vs 12%) or preventive dental (14% vs 6%) visits in the previous year, and had problems obtaining specialty care (40% vs 23%). Latino and Asian children in non-English-primary-language households had several unique disparities compared with white children in non-English-primary-language households. Almost all disparities

  16. Dental Care Every Day: A Caregiver's Guide

    Science.gov (United States)

    ... Health > Dental Care Every Day: A Caregiver's Guide Dental Care Every Day: A Caregiver's Guide Main Content ... appointments easier. Back to To Prepare for Every Dental Visit: Your Role Be prepared for every appointment. ...

  17. The relationship between access to and use of dental services following expansion of a primary care service to embrace dental team training.

    Science.gov (United States)

    Wanyonyi, K L; Radford, D R; Gallagher, J E

    2013-11-01

    To investigate changes in the patient population and treatment case-mix within an expanded primary care dental training facility in Southern England. Cross-sectional analysis of patient management system data. Electronic data for patients with a closed/completed treatment plan in the 12-month period prior to, and following, dental service expansion were extracted for analysis (n = 4343). Descriptive analysis involved age, sex, payment status, deprivation status and treatment activity. Logistic regression was used to model the likelihood of treatment involving laboratory constructed devices (crowns, bridges, dentures), in relation to demography and deprivation in each time period. The volume of patients using the service increased by 48.3% (1749 cf 2594). The average age increased from 31.97 (95%CI: 30.8, 32.5) to 36.4 years (95%CI: 35.6, 37.1); greatest increase was in the over 75 years age-group (96%). The patient base became less deprived: patients exempt from payment reduced from 43.2% (n = 755) to 28.6% (n = 741) (P = 0.001) and the mean population deprivation score (IMD) reduced from 24.5 (95%CI: 23.8, 25.2) to 22.3 (95%CI: 21.7, 22.8). The volume and proportion of care involving laboratory constructed devices increased from 8.3% (n = 145) to 15.8% (n = 411) whilst assessments without interventive care decreased (34.5%-26.3%). On a logistic regression, the odds of having treatment involving laboratory constructed devices, increased with increasing age in both time periods 7% (95% CI: 1.06-1.08) and 6% (95% CI: 1.05-1.07) respectively. Furthermore, the odds increased by 38% OR: 1.38 (95% CI: 1.01-1.89) in period 2, for white patients. After adjusting for these effects, the odds of having care that involved laboratory constructed devices were less in period 2 than period 1 (100% cf 43%) for those who were technically exempt from payment (OR = 2.0; 95% CI 1.34 to 2.90 cf, OR = 1.43; 95% CI 1.13-1.81). The patient population altered in relation to age and socio

  18. Acesso à assistência odontológica no acompanhamento pré-natal Access to dental care during prenatal assistance

    Directory of Open Access Journals (Sweden)

    Edson Theodoro dos Santos Neto

    2012-11-01

    educational activities was closely associated with adequate dental care (p < 0.05. Access to dental care is facilitated when pregnant women attend health services and become involved in educational activities during the prenatal period. Consequently, educational measures appear to indicate an improvement in prenatal care in the SUS.

  19. Dental care for the deaf pediatric patient

    Directory of Open Access Journals (Sweden)

    Rajat K Singh

    2012-01-01

    Full Text Available Great strides have been accomplished recently in providing better medical services for handicapped children. As the dentist begins to understand the complexity of each particular form of handicap and its characteristics, he is able to plan more efficiently for satisfactory treatment. Because many dentists do not understand deafness and the unique problems that deaf children exhibit, inadequate dental care for deaf children still ensues. Handicapped persons are at a greater risk for dental disease, for the most part, because of greater neglect or poor oral hygiene and access to routine dental care. Deaf patients in particular often fail to obtain needed care because of communication difficulties experienced in the treatment situation.

  20. Latex Allergy in Dental Care

    Directory of Open Access Journals (Sweden)

    Dermata A.

    2014-07-01

    Full Text Available Natural rubber latex is found in numerous medical and dental products. Adverse latex reactions in dental patients and practitioners have significantly increased since the introduction of universal precautions for infection control. These reactions range from contact dermatitis to potentially life-threatening hypersensitivity. Patients with a history of spina bifida, urogenital anomalies, multiple surgical procedures, allergic reactions or atopy, health care personnel and latex production workers are at increased risk of latex allergy. Diagnosis is based on a combination of clinical history and laboratory tests. Identification of latex sources and the avoidance of latex exposure are critical for protecting both dental patients and dental personnel.

  1. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    Science.gov (United States)

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  2. Access to dental public services by disabled persons.

    Science.gov (United States)

    Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya

    2015-03-13

    According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde--SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the accessibility of public dental services to persons with disabilities in Fortaleza, Ceará, which has the third highest disability rate in Brazil. A cross-sectional quantitative study using structured questionnaires was administered to dentists (n = 89) and people with disabilities (n = 204) to evaluate the geographical, architectural, and organizational accessibility of health facilities, the communication between professionals and patients with disabilities, the demand for dental services, and factors influencing the use of dental services by people with motor, visual, and hearing impairments. 43.1% of people with disabilities do not recognize their service as a priority of Basic Health Units (BHU), 52.5% do not usually seek dental care, and of those who do (n = 97), 76.3% find it difficult to receive care and 84.5% only seek care on an emergency basis. Forty-five percent are unaware of the services offered in the BHU. Of the dentists, 56.2% reported difficulty in communicating with deaf patients, and 97.8% desired interpreters stationed in the BHU. People with disabilities gave better accessibility ratings than dentists (p = 0.001). 37.3% of the patients and 43.8% of dentists reported inadequate physical access infrastructure (including doors, hallways, waiting rooms, and offices). Dentists (60%) reported unsafe environments and transportation difficulties as geographical barriers, while most people with disabilities did not report noticing these barriers. While access to dental

  3. Intergrated dental care in nursing homes

    NARCIS (Netherlands)

    Gerritsen, P.F.M.

    2015-01-01

    The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment.

  4. Intergrated dental care in nursing homes

    NARCIS (Netherlands)

    Gerritsen, P.F.M.

    2015-01-01

    The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment. How

  5. Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care: A Program Evaluation

    Science.gov (United States)

    Carpino, Rachel; Walker, Mary P.; Liu, Ying; Simmer-Beck, Melanie

    2017-01-01

    This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants (N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter…

  6. Health economic analyses of domiciliary dental care and care at fixed clinics for elderly nursing home residents in Sweden.

    Science.gov (United States)

    Lundqvist, M; Davidson, T; Ordell, S; Sjöström, O; Zimmerman, M; Sjögren, P

    2015-03-01

    Dental care for elderly nursing home residents is traditionally provided at fixed dental clinics, but domiciliary dental care is an emerging alternative. Longer life expectancy accompanied with increased morbidity, and hospitalisation or dependence on the care of others will contribute to a risk for rapid deterioration of oral health so alternative methods for delivering oral health care to vulnerable individuals for whom access to fixed dental clinics is an obstacle should be considered. The aim was to analyse health economic consequences of domiciliary dental care for elderly nursing home residents in Sweden, compared to dentistry at a fixed clinic. A review of relevant literature was undertaken complemented by interviews with nursing home staff, officials at county councils, and academic experts in geriatric dentistry. Domiciliary dental care and fixed clinic care were compared in cost analyses and cost-effectiveness analyses. The mean societal cost of domiciliary dental care for elderly nursing home residents was lower than dental care at a fixed clinic, and it was also considered cost-effective. Lower cost of dental care at a fixed dental clinic was only achieved in a scenario where dental care could not be completed in a domiciliary setting. Domiciliary dental care for elderly nursing home residents has a lower societal cost and is cost-effective compared to dental care at fixed clinics. To meet current and predicted need for oral health care in the ageing population alternative methods to deliver dental care should be available.

  7. Better Together: Co-Location of Dental and Primary Care Provides Opportunities to Improve Oral Health.

    Science.gov (United States)

    Pourat, Nadereh; Martinez, Ana E; Crall, James J

    2015-09-01

    Community Health Centers (CHCs) are one of the principal safety-net providers of health care for low-income and uninsured populations. Co-locating dental services in primary care settings provides an opportunity to improve access to dental care. Yet this study of California CHCs that provide primary care services shows that only about one-third of them co-located primary and dental care services on-site. An additional one-third were members of multisite organizations in which at least one other site provided dental care. The remaining one-third of CHC sites had no dental care capacity. Policy options to promote co-location include requiring on-site availability of dental services, providing infrastructure funding to build and equip dental facilities, and offering financial incentives to provide dental care and recruit dental providers.

  8. [Autism-friendly dental care].

    Science.gov (United States)

    Kind, L S; van Gemert-Schriks, M C M; Elhorst, J H

    2016-02-01

    Autism Spectrum Disorder (ASD) occurs in approximately 1% of the Dutch population. Among the group of patients with this disorder, there is a substantial diversity regarding skills, intelligence and treatability. However, there are also common characteristics; people with ASD often have difficulty with social interaction, communication, and exhibit typical patterns of behaviour. Therefore, problems may arise in the various areas of development, such as language development and responding to sensory stimuli. Dental practitioners will also be confronted with individuals with ASD. Care can be significantly improved, considering that negative experiences and dental anxiety are widespread at this time.

  9. The Swedish national dental insurance and dental health care policy

    DEFF Research Database (Denmark)

    Moore, Rod

    1981-01-01

    Sweden initiated a dental health care insurance in 1973. The health insurance is outlined, current problems and political issues are described. The benefits and limitations are described.......Sweden initiated a dental health care insurance in 1973. The health insurance is outlined, current problems and political issues are described. The benefits and limitations are described....

  10. Relationships between dental personnel and non-dental primary health care providers in rural and remote Queensland, Australia: dental perspectives.

    Science.gov (United States)

    Stuart, Jackie; Hoang, Ha; Crocombe, Len; Barnett, Tony

    2017-06-19

    Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants. Semi-structured interviews were conducted between 2013 and 2015 with visiting, local and regional dental practitioners (n = 12) who had provided dental services to patients from eight rural and remote Queensland communities that did not have a resident dentist. Participants were purposely recruited through a snow ball sampling technique. Interview data were analysed using thematic analysis with the assistance of QSR Nvivo v.10. Four major themes emerged from the data: (1) Communication between dental practitioners and rural primary care providers; (2) Relationships between dental and primary care providers; (3) Maintenance of professional dualism; (4) Strategies to improve interprofessional relationships (with subthemes: face to face meetings; utilisation of technology; oral health training for primary care providers; and having a community based oral health contact person). Participants observed that there was a lack of communication between the dental providers who saw patients from these rural communities and the primary care providers who worked in each community. This was attributed to poor communication, the high turnover of staff and the siloed behaviours of some practitioners. Visiting dental practitioners were likely to have stronger professional relationships with hospital nursing, administrative and allied health care staff who were often long term

  11. Minimising barriers to dental care in older people

    Directory of Open Access Journals (Sweden)

    Gallagher Jennifer E

    2008-03-01

    Full Text Available Abstract Background Older people are increasingly retaining their natural teeth but at higher risk of oral disease with resultant impact on their quality of life. Socially deprived people are more at risk of oral disease and yet less likely to take up care. Health organisations in England and Wales are exploring new ways to commission and provide dental care services in general and for vulnerable groups in particular. This study was undertaken to investigate barriers to dental care perceived by older people in socially deprived inner city area where uptake of care was low and identify methods for minimising barriers in older people in support of oral health. Methods A qualitative dual-methodological approach, utilising both focus groups and individual interviews, was used in this research. Participants, older people and carers of older people, were recruited using purposive sampling through day centres and community groups in the inner city boroughs of Lambeth, Southwark and Lewisham in South London. A topic guide was utilised to guide qualitative data collection. Informants' views were recorded on tape and in field notes. The data were transcribed and analysed using Framework Methodology. Results Thirty-nine older people and/or their carers participated in focus groups. Active barriers to dental care in older people fell into five main categories: cost, fear, availability, accessibility and characteristics of the dentist. Lack of perception of a need for dental care was a common 'passive barrier' amongst denture wearers in particular. The cost of dental treatment, fear of care and perceived availability of dental services emerged to influence significantly dental attendance. Minimising barriers involves three levels of action to be taken: individual actions (such as persistence in finding available care following identification of need, system changes (including reducing costs, improving information, ensuring appropriate timing and location of

  12. Hemodialysis access - self care

    Science.gov (United States)

    Kidney failure - chronic-hemodialysis access; Renal failure - chronic-hemodialysis access; Chronic renal insufficiency - hemodialysis access; Chronic kidney failure - hemodialysis access; Chronic renal failure - ...

  13. Ethnic classification in primary dental care and dental health services research: time to pause for thought.

    Science.gov (United States)

    Buck, D J; Malik, S; Murphy, N; Patel, V; Singh, S; Syed, B; Vora, N

    2001-04-01

    'Ethnicity' is an important concept in dental health services research and in enabling general dental practitioners to gain insight into their patients values and expectations. Since more health services research is being undertaken in primary dental care settings it is becoming an important issue for dental professionals and researchers in primary care to be aware of. Ethnicity is thought to be related to dental health inequalities and access and is often used as a stratifying variable in many dental studies. The meaning and use of the term however differs among researchers and among the public. It is clear that researchers and professionals need to pause for thought when considering what this often bandied about term actually means and the impact of different definitions. This is illustrated using examples from the authors' own research and published papers in the medical and dental literature. There is also much debate about whether ethnicity--however defined--is an important predictor of differences in dental health in itself or is merely a marker for other factors such as social deprivation or the impact of 'place' on dental health. While the jury on this debate is out we suggest guidelines on the reporting of ethnicity should be outlined in the dental literature--perhaps updating those published in 1996 in the British Medical Journal.

  14. Dental anxiety and salivary cortisol levels before urgent dental care.

    Science.gov (United States)

    Kanegane, Kazue; Penha, Sibele S; Munhoz, Carolina D; Rocha, Rodney G

    2009-12-01

    Dental anxiety is still prevalent, despite advances in treatment, and affects the utilization of health care services. The purpose of this cross-sectional study was to determine if patients with different degrees of dental anxiety and pain undergoing emergency dental care have different stress reactions as measured by salivary cortisol. Seventy three patients completed the modified dental anxiety scale (MDAS), and described any previous dental traumatic experience. Their socio-demographic characteristics were also recorded. They also rated pain intensity on a 100 mm visual analogue scale (VAS). A saliva sample was collected before the procedure, and analyzed by enzyme immunoassay. Thirty patients were dentally anxious and forty one complained of pain. In this sample, dental anxiety was not related to gender, age, educational level and family income; however, a previous traumatic event was related to dental anxiety. There was no association between salivary cortisol concentrations and gender or dental anxiety. Patients with pain showed higher cortisol levels. When gathering patient information, the dentist should note patients' negative dental experiences in order to provide more effective, less traumatic treatment.

  15. Dental care for aging populations in Denmark, Sweden, Norway, United kingdom, and Germany

    DEFF Research Database (Denmark)

    Holm-Pedersen, Poul; Vigild, Merete; Nitschke, Ina

    2005-01-01

    care to these patients. One reason may be that the fee for treating these patients is too low, considering high dental office expenses. Another reason may be problems related to management of medically compromised patients. This raises an important question: does inadequate training in geriatric...... dentistry discourage dentists from seeking opportunities to treat geriatric patients? Overall, the availability of dental services, the organization of the dental health care delivery system, and price subsidy for dental treatment are important factors influencing access to dental care among older people......This article reviews access to and financing of dental care for aging populations in selected nations in Europe. Old age per se does not seem to be a major factor in determining the use of dental services. Dentition status, on the other hand, is a major determinant of dental attendance. In addition...

  16. Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

    Science.gov (United States)

    Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

    2013-06-01

    Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

  17. Dental care and children with special health care needs: a population-based perspective.

    Science.gov (United States)

    Lewis, Charlotte W

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.

  18. Parents’ satisfaction with pediatric dental care provided by dental college, Riyadh

    Science.gov (United States)

    AlMutairi, Manal A.

    2016-01-01

    Aims and Objectives: To evaluate the level of parents’ satisfaction with pediatric dental care provided by dental students at the College of Dentistry and explore the factors associated with various parents’ demographics. Materials and Methods: A cross-sectional study was conducted among parents (n = 150) whose children received dental care in dental colleges in King Saud University (KSU) in Riyadh. The parents were asked to fill a self-administered dental satisfaction questionnaire between Februry and April 2016. Data were recorded and analyses using the Statistical Package for the Social Sciences Version 20 (SPSS Inc., Chicago, IL, USA). Results: Results indicated that only 10.7% of the parents strongly agreed that before being seen they had to wait for a long time in the waiting area, and 36% strongly agreed that one of the causes for which they went to the KSU dental college is that there were inadequate pedodontics in their region. More than half of parents (60%) strongly agreed that the KSU dental clinic is up to date and very modern. Conclusions: The results indicate that the pediatric department has been successful in achieving parents’ satisfaction with dental students, their treatment, as well as operational aspects related to access. There was a strong degree of satisfaction from parents regarding the KSU dental college being modern and up to date. PMID:28032046

  19. STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.

    Science.gov (United States)

    Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R

    2016-02-01

    Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population.

  20. MCBS Access to Care PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MCBS 2013 Access to Care public use file (MCBS PUF) provides the first publically available MCBS file for researchers interested in the health, health care use,...

  1. Dental Care - Medicaid and Chip

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dental health is an important part of peoples overall health. States are required to provide dental benefits to children covered by Medicaid and the Childrens Health...

  2. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.

    Science.gov (United States)

    Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel

    2016-12-01

    The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults.

  3. Insure Kids Now (IKN) (Dental Care Providers)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Insure Kids Now (IKN) Dental Care Providers in Your State locator provides profile information for oral health providers participating in Medicaid and Children's...

  4. The relation between gender and access to dental services and goods

    Directory of Open Access Journals (Sweden)

    Maria Vieira de Lima Saintrain

    2014-09-01

    Full Text Available ABSTRACT The Brazilian National Health System guarantees universal access to health services. However, this universal access is not always achieved, making relevant studies that evaluate access to health care and the way gender influence this access. Objective: Identify the influence of gender in the access to dental services and goods such as consultation, toothbrush, toothpaste and dental prostheses use in Brazil’s Northeast region. Methods: Cross-sectional, quantitative and population coverage study, with the population of Guaiuba municipality. Data were collected by Community Health Agents from July 2007 to February 2008. We used the Community Oral Health Indicator to verify the access to oral health services, oral hygiene, dental visit, use and need of dental prosthesis. Data were analyzed using SPSS 15.0 software, using the chi-square test and significance level of 5%. Results: 2581 people participated, with a mean age of 24.42 years (SD± 19, 365, with 1628 female (63.1%. Among the interviewees, 2,341 (90.7% had access to a toothbrush, 2272 (88.0% to toothpaste, and 1175 (45.5% to a dental appointment. The need for dental prosthesis was higher in women, 581 (35.7% versus 221 (23.2% men and their access [354 (60.9%] versus [96 (43.4%] with p<0.05. Conclusion: The access to health services and dental treatment presents gender as an influence factor. Women have most of the needs and benefits. The edentulism affects mostly the population with a poor access to dental prosthesis.

  5. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...... municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should...

  6. Qualitative description of dental hygiene practices within oral health and dental care perspectives of Mexican-American adults and teenagers.

    Science.gov (United States)

    Maupome, Gerardo; Aguirre-Zero, Odette; Westerhold, Chi

    2015-01-01

    The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources. © 2014 American Association of Public Health Dentistry.

  7. patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    2006-04-04

    Apr 4, 2006 ... known with regard to equity, efficiency, geographical equality of access, patient ... (vi) Physical environment features of setting in which care is delivered: (e.g. .... This exercise, which will involve equipping the clinics with the ...

  8. Referrals for dental care during pregnancy.

    Science.gov (United States)

    Kloetzel, Megan K; Huebner, Colleen E; Milgrom, Peter

    2011-01-01

    Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly.

  9. Towards building the oral health care workforce: who are the new dental therapists?

    Science.gov (United States)

    Blue, Christine M; Lopez, Naty

    2011-01-01

    In 2009, Minnesota Governor Pawlenty signed into law a bill approving the creation of a new dental team member: the dental therapist. The intent of this legislation was to address oral health disparities by creating a dental professional who would expand access to dental care in Minnesota. This study aimed to describe the characteristics of the first class of dental therapy students at the University of Minnesota and to ascertain the values and motivations that led them to choose a career in dental therapy. Four surveys were used to create the composite profile of the ten students in this first dental therapy class: 1) the California Critical Thinking Skills Test, 2) the Learning Type Measure, 3) the Attitudes Toward Healthcare Survey, and 4) a values and motivation survey that included demographic data. The results of the surveys revealed interacting influences of the students' background, personal self-concept, and environment leading to a career decision to pursue dental therapy.

  10. Relationship Between Children’s Dental Needs and Dental Care Utilization: United States, 1988–1994

    Science.gov (United States)

    Vargas, Clemencia M.; Ronzio, Cynthia R.

    2002-01-01

    Objectives. This study describes the relationship between dental needs and dental care utilization among children. Methods. Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to analyze dental care needs and dental care utilization. Results. Younger children with perceived needs (needs perceived by the child or responsible adult) were more likely to be episodic users of dental care than children without perceived needs. Younger children with normative needs (defined by the presence of untreated caries diagnosed by a dentist) were less likely to be regular users. Older children with perceived or normative needs were more likely to be episodic users and less likely to have had a previous-year visit than children with no needs. Conclusions. Despite their presence, dental needs do not drive dental care use among children, and children’s dental care utilization is inadequate. PMID:12406814

  11. [The social value of teeth and access to dental health services].

    Science.gov (United States)

    Fonseca, Luciara Leão Viana; Nehmy, Rosa Maria Quadros; Mota, Joaquim Antônio César

    2015-10-01

    Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right.

  12. Disparities in unmet dental need and dental care received by pregnant women in Maryland.

    Science.gov (United States)

    Singhal, Astha; Chattopadhyay, Amit; Garcia, A Isabel; Adams, Amy B; Cheng, Diana

    2014-09-01

    To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001-2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women's attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001-2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.

  13. Washington state foster care: dental utilization and expenditures.

    Science.gov (United States)

    Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

    2014-01-01

    To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population Care [$28.57 95% CI($14.00, $43.15)]. Most children enrolled in WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

  14. Improving the dental fitness of the British Army by changing the strategy for dental care provision for recruits from a vertically equitable model to a horizontally equitable model.

    Science.gov (United States)

    Hurley, Sara Jane; Tuck, Jeremy

    2007-11-01

    BACKGROUNDd: The dental health of the British Army has been reported as being in decline for the past 10 years, and this is having a significant impact on operations. One of the major factors in the decline is the increasing number of recruits who enlist with outstanding dental treatment needs. The current policy for provision of routine dental care to recruits targets resources toward those with the worst dental health and provides only emergency dental care for the remainder.AIMSs: The goal was to review recruit dental care provision, to determine whether improvements in the overall dental health of the trained Army could be made during recruit training.RESULTSs: It was found that >85% of recruit dental treatment need could be met with the routine provision of 2 hours of dental treatment during training.CONCLUSIONn: A horizontally equitable model of recruit dental care, whereby all recruits access routine dental care during training, has been recommended to and accepted by the chain of command.

  15. Estimating Demand for and Supply of Pediatric Preventive Dental Care for Children and Identifying Dental Care Shortage Areas, Georgia, 2015.

    Science.gov (United States)

    Cao, Shanshan; Gentili, Monica; Griffin, Paul M; Griffin, Susan O; Harati, Pravara; Johnson, Ben; Serban, Nicoleta; Tomar, Scott

    Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive dental care supply exceeded demand in Georgia in 75 counties: the average annual county-level pediatric preventive dental care demand was 16 866 hours, and the supply was 32 969 hours. We identified 41 counties as pediatric dental care shortage areas, 14 of which had not been designated by the Health Resources & Services Administration. Age- and service-specific information on dental care shortage areas could result in more efficient provider staffing and geographic targeting.

  16. Dental Care Utilization for Examination and Regional Deprivation

    Science.gov (United States)

    Kim, Cheol-Sin; Han, Sun-Young; Lee, Seung Eun; Kang, Jeong-Hee; Kim, Chul-Woung

    2015-01-01

    Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (pdental care utilization for other reasons in the final model. Conclusions: This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination. PMID:26265665

  17. Utilization of dental health services by Danish adolescents attending private or public dental health care systems

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise

    2002-01-01

    The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative...... systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88......% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (Pdental services were provided more frequently by the public than the private system (P

  18. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care,...

  19. Medical care providers' perspectives on dental information needs in electronic health records.

    Science.gov (United States)

    Acharya, Amit; Shimpi, Neel; Mahnke, Andrea; Mathias, Richard; Ye, Zhan

    2017-05-01

    The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. Barriers to dental care for children with special needs: General dentists' perception in Kerala, India.

    Science.gov (United States)

    Adyanthaya, Amith; Sreelakshmi, Natta; Ismail, Sajeela; Raheema, Marium

    2017-01-01

    Special children are among the underserved dental patient groups around the globe. Oral health care for disabled children remain an unmet challenge. One out of two persons with a significant disability cannot find a professional resource to provide appropriate dental care. Identification of barriers can be the first step in addressing the deficiencies in dental care for such patients. To investigate the perception of dental practitioners in Kerala, India regarding the hurdles faced by them in providing dental care to Special Needs Children including the challenges faced by them. 149 dental professionals were interviewed through a questionnaire for their perceived barriers to provide oral health care for children with special needs. The data was obtained and Chi-square test, Pearson correlation coefficient and logistic regression model were assessed using the SPSS version 20.0. All analyses were performed using a level of 0.05 for statistical significance. Greatest barriers as perceived by the practitioners were their level of training and lack of motivation of caretakers. Significant association was found between experience of the dentist with the frequency with which they reported seeing children with special needs (pConclusion: Findings from this study provide a valid picture of barriers to access for children with special needs within general dental private practice system. Recommendations for amendment of undergraduate dental curriculum is made in order to equip future graduates to deal with this group of children better.

  1. Barriers to dental care for children with special needs: General dentists' perception in Kerala, India

    Directory of Open Access Journals (Sweden)

    Amith Adyanthaya

    2017-01-01

    Full Text Available Introduction: Special children are among the underserved dental patient groups around the globe. Oral health care for disabled children remain an unmet challenge. One out of two persons with a significant disability cannot find a professional resource to provide appropriate dental care. Identification of barriers can be the first step in addressing the deficiencies in dental care for such patients. Aim: To investigate the perception of dental practitioners in Kerala, India regarding the hurdles faced by them in providing dental care to Special Needs Children including the challenges faced by them. Materials and Method: 149 dental professionals were interviewed through a questionnaire for their perceived barriers to provide oral health care for children with special needs. Statistical analysis: The data was obtained and Chi-square test, Pearson correlation coefficient and logistic regression model were assessed using the SPSS version 20.0. All analyses were performed using a level of 0.05 for statistical significance. Results: Greatest barriers as perceived by the practitioners were their level of training and lack of motivation of caretakers. Significant association was found between experience of the dentist with the frequency with which they reported seeing children with special needs (p< 0.05. Conclusion: Findings from this study provide a valid picture of barriers to access for children with special needs within general dental private practice system. Recommendations for amendment of undergraduate dental curriculum is made in order to equip future graduates to deal with this group of children better.

  2. Factors associated with the use of dental health services in primary care in northeastern Mexico.

    Directory of Open Access Journals (Sweden)

    Guillermo Cruz

    2016-09-01

    Full Text Available In Mexico, as in many other Latin American countries, the use of dental health services (UDHS has been scarcely studied, especially the one related with groups that are considered at risk in certain areas. The aim of this study was to evaluate the factors associated with UDHS in an at risk population in primary care. Material and Methods: Cross-sectional study, involving students (T, pregnant women (PW, workers (W and older adults (OA (n=368. Variables such as the use of dental health services and factors such as geographical, economic, and organizational barriers were measured. Descriptive statistics, Chi Square test and multivariate binary logistic regression analysis were used. Results: 40.2% (95% CI 30.2-50.2 of the W group had a history of UDHS in primary care, 20% (95% CI 11.8-28.2 of the PW group had spent more than a year without visiting the dentist and 33% (95% CI 23.7-43.9 had been treated at a private dental care service. Level of schooling, occupation, federal support from "Programa Oportunidades" and access to dental care services (p<0.01 were factors associated with UDHS, independent of potential confounders. Conclusion: The health system should guarantee health care by offering comprehensive dental health services and removing organizational barriers to promote a more equitable access to dental care.

  3. Dental attendance patterns among older people: a retrospective review of records in public and private dental care in Sweden.

    Science.gov (United States)

    Derblom, C; Hagman-Gustafsson, M-L; Gabre, P

    2016-11-20

    Nowadays, older people retain their natural teeth more frequently and so are at increased risk of oral disease. At the same time, discontinued contacts with dental services prevent access to preventive care and increase the risk of undetected disease. This study aims to evaluate how often older people discontinue regular dental visits and to establish the reasons. This study is a retrospective review of records of patients aged ≥75 years from seven Swedish clinics, three in the public dental service (PuDS) and four in the private (PrDS). All patients were examined in 2010, and their dental attendance records from 2010 to 2014 studied. Data included gender, dental insurance system, last performed planned examination, emergency visits, registrations in the recall system, cause of discontinued care and number of teeth and implants. In total, 993 records were studied, 303 in PuDS and 690 in PrDS. In both groups, 10% of patients had no complete dental examinations between 2010 and 2014 after baseline examination in 2010. One-quarter were not registered in the recall system after their last examinations, and this was more common in PrDS than PuDS. In many cases, no reason for discontinued regular visits were described in the records. The mean number of natural teeth was 19.0 in both groups, but there were more implants in the PrDS group. A large proportion of the participants risked losing regular contact with dental services. Dental services appeared to lack strategies for maintaining regular dental care for elderly patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Do children get their fair share of health and dental care?

    Science.gov (United States)

    Kopelman, L M; Mouradian, W E

    2001-04-01

    This paper reviews the work of several authors, D.W. Brock, D. Callahan, L. Churchill, L.M. Kopelman, R. Tong who consider assumptions and arguments about how to allocate health and dental care to children fairly. They use various approaches including feminist, rights based, and principled considerations, applying general notions of duty or justice to the issues of children's access to basic health and dental care. Two discuss these issues in relation to the work of David Hume. These authors consider children's greatest unmet health needs, including that of dental care, often mistakenly regarded as medically unimportant in terms of children's wellbeing, opportunities, and self-image. They review possible age bias against children in the allocation of health and dental care, the gap between what we say and do where children are concerned, and whether some fundamental shift in social thinking needs to occur.

  5. The development, implementation, utilization and outcomes of a comprehensive dental program for older adults residing in long-term care facilities.

    Science.gov (United States)

    Wyatt, Chris C L; So, Frankie H C; Williams, P Michele; Mithani, Akber; Zed, Christopher M; Yen, Edwin H K

    2006-06-01

    This paper documents the experience of the University of British Columbia's Geriatric Dentistry Program (GDP) with emphasis on the dental treatment needs of patients during its first year of operation. The GDP provided access to dental care for residents of longterm care facilities, education for hospital staff concerning daily mouth care, education of dental students and an opportunity for research. The first year of clinical activity saw a small, yet significant, improvement in oral health for residents using the dental services. We hope that the outcomes of this new dental program for long-term care facilities will encourage dentists to provide care for this vulnerable population.

  6. Factors associated with dental care utilization in early childhood

    National Research Council Canada - National Science Library

    Darmawikarta, Denise; Chen, Yang; Carsley, Sarah; Birken, Catherine S; Parkin, Patricia C; Schroth, Robert J; Maguire, Jonathon L

    2014-01-01

    To identify sociodemographic, dietary, and biological factors associated with families who do not receive dental care in early childhood and to identify risk factors associated with having cavities...

  7. Factors related to the performance of Specialized Dental Care Centers

    Directory of Open Access Journals (Sweden)

    Flávia Christiane de Azevedo Machado

    2015-04-01

    Full Text Available The Specialized Dental Care Centers (SDCC have the mission to expand access to public medium complexity dental care and support the primary health care actions at this level of complexity. However, it is necessary to ensure the quality of services and to evaluate such services continuously to identify weaknesses and strengths that support the processes of leadership/management. Nevertheless, there is a dearth of studies on the assessment of oral health in specialized care that may indicate which factors should be investigated. Therefore, this integrated literature review sought to explore the plethora of publications on the evaluation of SDCC in the LILACS and MEDLINE data bases in October 2013 to identify factors possibly related to the performance of such health services. Thus, 13 references were included in this review pointing to forms of organization and management of work processes related to the creation of healthcare networks (operation of regulation centers and setting up of health consortiums. They include the contextual characteristics of the places where SDCCs are located (population size, Family Health Strategy coverage, Municipal Human Development Index, governance, governing capacity were factors that influenced the SDCCs performance.

  8. Application of fuzzy classification in modern primary dental care

    Directory of Open Access Journals (Sweden)

    Yauheni Veryha

    2005-03-01

    Full Text Available This paper describes a framework for implementing fuzzy classifications in primary dental care services. Dental practices aim to provide the highest quality services for their patients. To achieve this, it is important that dentists are able to obtain patients' opinions about their experiences in the dental practice and are able to accurately evaluate this. We propose the use of fuzzy classification to combine various assessment criteria into one general measure to assess patients' satisfaction with primary dental care services. The proposed framework can be used in conventional dental practice information systems and easily integrated with those already used. The benefits of using the proposed fuzzy classification approach include more flexible and accurate analysis of patients' feedback, combining verbal and numeric data. To confirm our theory, a prototype was developed based on the Microsoft TM SQL Server database management system for two criteria used in dental practices, namely making an appointment with a dentist and waiting time for dental care services.

  9. Professional monopoly, social covenant, and access to oral health care in the United States.

    Science.gov (United States)

    Benn, Douglas K

    2003-10-01

    Lack of access to oral care is a severe problem in the United States with over one-third of the population lacking dental insurance. In this group, 32 million people lack dental insurance and access to public dental services (Medicaid or Medicare), and 7 million of them need dental care. In some high-risk populations, such as Native Americans, two-thirds have unmet dental needs. Only 1 percent of Medicaid-eligible babies have a dental examination before twelve months of age. In this paper the social covenant of the dental profession is examined and suggestions made for improving access to care through improved efficiency. It is proposed that 1) private dentists should accept 5 percent per annum of their patients for indigent care funded by improved efficiency from utilizing allied dental providers (ADP) in new roles, and 2) ADP should have their own independent state boards. If dentists refuse to honor their social covenant, then ADP should be allowed to practice independently, breaking the professional monopoly.

  10. A comparison of paediatric dentists' and general dental practitioners' care patterns in paediatric dental care

    NARCIS (Netherlands)

    Schorer-Jensma, M.A.; Veerkamp, J.S.J.

    2010-01-01

    AIM: The aim of this study was to compare the care patterns of paediatric dentists and general dentists in the dental treatment of children in the Netherlands. STUDY DESIGN AND METHODS: A case control study was completed based on the financial records of one of the largest Dutch health insurance com

  11. [Dental care for foreigners in Hungary].

    Science.gov (United States)

    Balázs, Péter; Oesterle, August

    2008-10-01

    High quality elective dental care for foreign patients was not exceptional in Hungary before the collapse of the old regime in 1989. Nevertheless, it became business as usual only in the new era thanks to the open state borders and the international competitive market environment. Unfortunately, no scientific study concerning this phenomenon has been conducted so far, however its professional and economic significance has been indicated by day-to-day experience. Additionally, the term "dental tourism" also used in international scientific papers became a commonplace in Hungary with unfavourable connotations. The present survey was the first to study this phenomenon by scientific standards in the most involved areas, namely in the capital city Budapest and in three counties in the Western Hungarian Region. Data collecting was performed by a self-reported questionnaire sent via conventional mail to all members of the Dental Section of the Hungarian Medical Chamber practicing in those indicated regions. Respond rates were 20.65% in Budapest and 25.34% in Western Hungary. The sample obtained this way, clearly indicated dimensions of cross-border patient migration and its economic significance as well. In Western Hungary 80.81% of foreign patients came from the neighbouring Austria and two out of ten practices realized 40 to 100% of their income out of this business. In Budapest foreign patients' nationality was more diversified. The largest group arrived from the United Kingdom (9.93%). Nevertheless the economic impact of dental tourism in Budapest is not relevant and outbalanced by a considerable domestic demand on the local private market.

  12. Open access in the critical care environment.

    Science.gov (United States)

    South, Tabitha; Adair, Brigette

    2014-12-01

    Open access has become an important topic in critical care over the last 3 years. In the past, critical care had restricted access and set visitation guidelines to protect patients. This article provides a review of the literature related to open access in the critical care environment, including the impact on patients, families, and health care providers. The ultimate goal is to provide care centered on patients and families and to create a healing environment to ensure safe passage of patients through their hospital stays. This outcome could lead to increased patient/family satisfaction.

  13. Health insurance and access to care among welfare leavers.

    Science.gov (United States)

    Danziger, Sheldon; Davis, Matthew M; Orzol, Sean; Pollack, Harold A

    2008-01-01

    This analysis explores the effects of the 1996 welfare reform on health insurance coverage and access to care among former recipients of cash aid. Using panel data from the Women's Employment Study, which conducted five interviews between 1997 and 2003 in one Michigan county, we find that 25% of welfare leavers lacked health insurance coverage in fall 2003. Uninsured adults were significantly more likely than others to report that they could not afford a medical or dental visit during the year prior to the 2003 interview. Fixed-effect logistic regression analysis indicates that women who had been off the welfare rolls for at least 12 months (the duration of transitional Medicaid) were significantly more likely to be uninsured than women who had made more recent welfare exits, and were significantly more likely to report financial obstacles to the receipt of medical and dental care.

  14. Factors associated with dental care utilization in early childhood.

    Science.gov (United States)

    Darmawikarta, Denise; Chen, Yang; Carsley, Sarah; Birken, Catherine S; Parkin, Patricia C; Schroth, Robert J; Maguire, Jonathon L

    2014-06-01

    To identify sociodemographic, dietary, and biological factors associated with families who do not receive dental care in early childhood and to identify risk factors associated with having cavities among children who receive early dental care. A cross-sectional study of healthy Canadian children seen for primary health care between September 2011 and January 2013 was conducted through the TARGet Kids! practice-based research network in Toronto, Canada. Adjusted logistic regression was used to determine factors associated with children who were not seen by a dentist in early childhood and to determine risk factors associated with having dental cavities among children who received early dental care. Of the 2505 children included in the analysis, cavities. Among healthy urban children seen by a primary care provider, those most susceptible to cavities were least likely to receive early dental care. These findings support the need for publicly funded universal early preventive dental care and underscore the importance for primary care physicians to promote dental care in early childhood. Copyright © 2014 by the American Academy of Pediatrics.

  15. Basic principles of dental office logistics: organizing dental supplies and equipment for optimal accessibility.

    Science.gov (United States)

    Mamoun, John

    2012-01-01

    To maximize office production, dentists should continuously perform treatment-related tasks throughout the workday. To this end, the office should logically organize and store dental instruments, disposables, materials, handpieces, and small equipment to optimize accessibility of these items at the moment when the dentist needs them. The office needs multiple copies of these items to prevent their inaccessibility during the workday due to breakdown, inventory depletion, or lack of a sterilized copy of the item when needed. Staff should know where all items are located in the office at all times to minimize the time needed to search for them. This article describes how to organize dental items in an office for optimal accessibility to the dentist during procedures.

  16. A qualitative study of extended care permit dental hygienists in Kansas.

    Science.gov (United States)

    Delinger, Janette; Gadbury-Amyot, Cynthia C; Mitchell, Tanya Villalpando; Williams, Karen B

    2014-06-01

    Currently, 37 states allow some type of alternative practice settings for dental hygienists. This qualitative study was designed to explore the experiences of the Extended Care Permit (ECP) dental hygienist in the state of Kansas. As a first ever study of this workforce model, a qualitative research design was chosen to illuminate the education and experiences of extended dental hygiene practitioners in order to understand the impact ECP legislation has had on increasing the public's access to oral health care services and define the advantages and limitation of this model as one potential solution to access to oral care. Snowball sampling was used to identify study participants who were actively engaged in extended care practice. Nine subjects, which included one ECP consultant and eight ECP providers, participated in this study. Data obtained via personal interviews and through document analysis data were subsequently coded and thematically analyzed by three examiners. An independent audit was conducted by a fourth examiner to confirm dependability of results. Seven major categories emerged from the data analysis: entrepreneur dental hygienist, partnerships, funding, barriers, sustainability, models of care and the impact of the ECP. The findings of this study revealed that ECP hygienists are making an impact with underserved populations, primarily children, the elderly and special needs patients. Copyright © 2014 The American Dental Hygienists’ Association.

  17. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  18. Child Health and Access to Medical Care

    Science.gov (United States)

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  19. Prevalence of dental caries and dental care utilisation in preschool urban children enrolled in a comparative-effectiveness study.

    Science.gov (United States)

    Kopycka-Kedzierawski, D T; Billings, R J

    2011-06-01

    To assess dental caries prevalence and dental care utilisation in pre-school children enrolled in urban childcare centres that participated in a comparative effectiveness study. Cross-sectional study. Caries prevalence was determined in a cohort of children 12-60 months of age. Eligible children were randomised into two groups: group one received a traditional visual/tactile oral examination and group two received a teledentistry examination. Questionnaires were administered to the children's parents/guardians to gather demographics and information about using dental and medical services. Of 234 children examined, approximately 28% had caries experience. The mean dfs score was 1.56 with a range of 0-34 carious surfaces. The mean dfs score for the children examined by means of teledentistry was 1.75 and for the children examined by means of the traditional visual/tactile method mean dfs was 1.40; the means between the two groups were not significantly different. Twenty-six children showed evidence of being treated for dental caries. According to the parents, 31.5% of the children had never had a dental check-up before, only 3% of the children were lacking dental insurance and majority of the parents (92%) did not perceive accessing dental care for the children as a problem. The Wilcoxon Mann-Whitney test and the Kruskal-Wallis test were used to assess statistical differences among groups of children. The data showed that 28% of the children had caries and, of these, 61% had never been treated for caries, thus indicating that continued efforts are needed to improve oral health care utilisation by inner-city preschool children.

  20. Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.

    2012-01-01

    Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875

  1. Experiences of dental care: what do patients value?

    Directory of Open Access Journals (Sweden)

    Sbaraini Alexandra

    2012-06-01

    Full Text Available Abstract Background Dentistry in Australia combines business and health care service, that is, the majority of patients pay money for tangible dental procedures such as fluoride applications, dental radiographs, dental fillings, crowns, and dentures among others. There is evidence that patients question dentists’ behaviours and attitudes during a dental visit when those highly technical procedures are performed. However, little is known about how patients’ experience dental care as a whole. This paper illustrates the findings from a qualitative study recently undertaken in general dental practice in Australia. It focuses on patients’ experiences of dental care, particularly on the relationship between patients and dentists during the provision of preventive care and advice in general dental practices. Methods Seventeen patients were interviewed. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. Results Patients described their experiences when visiting dental practices with and without a structured preventive approach in place, together with the historical, biological, financial, psychosocial and habitual dimensions of their experience. Potential barriers that could hinder preventive activities as well as facilitators for prevention were also described. The offer of preventive dental care and advice was an amazing revelation for this group of patients as they realized that dentists could practice dentistry without having to “drill and fill” their teeth. All patients, regardless of the practice they came from or their level of clinical risk of developing dental caries, valued having a caring dentist who respected them and listened to their concerns without “blaming” them for their oral health status. These patients complied with and supported the preventive care options because they were being “treated as a person not as a patient” by their dentists. Patients valued dentists who made

  2. Genetic variations associated with red hair color and fear of dental pain, anxiety regarding dental care and avoidance of dental care.

    Science.gov (United States)

    Binkley, Catherine J; Beacham, Abbie; Neace, William; Gregg, Ronald G; Liem, Edwin B; Sessler, Daniel I

    2009-07-01

    Red hair color is caused by variants of the melanocortin-1 receptor (MC1R) gene. People with naturally red hair are resistant to subcutaneous local anesthetics and, therefore, may experience increased anxiety regarding dental care. The authors tested the hypothesis that having natural red hair color, a MC1R gene variant or both could predict a patient's experiencing dental care-related anxiety and dental care avoidance. The authors enrolled 144 participants (67 natural red-haired and 77 dark-haired) aged 18 to 41 years in a cross-sectional observational study. Participants completed validated survey instruments designed to measure general and dental care-specific anxiety, fear of dental pain and previous dental care avoidance. The authors genotyped participants' blood samples to detect variants associated with natural red hair color. Eighty-five participants had MC1R gene variants (65 of the 67 red-haired participants and 20 of the 77 dark-haired participants) (P fear of dental pain than did participants with no MC1R gene variants. They were more than twice as likely to avoid dental care as were the participants with no MC1R gene variants, even after the authors controlled for general trait anxiety and sex. Dental care-related anxiety, fear of dental pain and avoidance of dental care may be influenced by genetic variations. Dentists should evaluate all patients, but especially those with naturally red hair, for dental care-related anxiety and use appropriate modalities to manage the patients' anxiety.

  3. Dental Care Coverage and Use: Modeling Limitations and Opportunities

    Science.gov (United States)

    Moeller, John F.; Chen, Haiyan

    2014-01-01

    Objectives. We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage. Methods. We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use. Results. Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth. Conclusions. Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use. PMID:24328635

  4. Racial and ethnic disparities in dental care for publicly insured children.

    Science.gov (United States)

    Pourat, Nadereh; Finocchio, Len

    2010-07-01

    Poor oral health has important implications for the healthy development of children. Children in Medicaid, especially Latinos and African Americans, experience high rates of tooth decay, yet they visit dentists less often than privately insured children. Even Latino and African American children with private insurance are less likely than white children to visit dentists and have longer intervals between dental visits. Furthermore, Latino and African American children in Medicaid are more likely than white children in Medicaid to have longer intervals between visits. These findings raise concerns about Medicaid's ability to address disparities in dental care access and, more broadly, in health care.

  5. Dental Care among Young Adults with Intellectual Disability

    Science.gov (United States)

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2013-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…

  6. Curricular Guidelines for Dental Hygiene Care for the Handicapped.

    Science.gov (United States)

    Journal of Dental Education, 1984

    1984-01-01

    The American Association of Dental Schools' guidelines for dental hygiene curriculum cover the scope and definitions of care for the handicapped, interrelationships between disciplines and courses, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, sequencing, faculty, and…

  7. Dental Care among Young Adults with Intellectual Disability

    Science.gov (United States)

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2013-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…

  8. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    to reduce the global burden of disease (GBD), it is ... global players have supported efforts to improve access and safety of surgery ... (i) strengthening surgical services at district hospitals ... of the surrounding community and a model for other.

  9. Dental Care Every Day: A Caregiver's Guide. Practical Oral Care for People with Developmental Disabilities

    Science.gov (United States)

    National Institute of Dental and Craniofacial Research (NIDCR), 2009

    2009-01-01

    Taking care of someone with a developmental disability requires patience and skill. As a caregiver, you know this as well as anyone does. You also know how challenging it is to help that person with dental care. It takes planning, time, and the ability to manage physical, mental, and behavioral problems. Dental care isn't always easy, but you can…

  10. Measuring quality of dental care: Caries prevention services for children

    National Research Council Canada - National Science Library

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-01-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries...

  11. Dental Care for a Child with Cleft Lip and Palate

    Science.gov (United States)

    ... Volunteer Efforts Dental Care for a Child with Cleft Lip and Palate skip to submenu Parents & Individuals Information for Parents & ... version of this factsheet, click here How does cleft lip/palate affect the teeth? A cleft of the lip, ...

  12. Health Care Access Among Deaf People

    National Research Council Canada - National Science Library

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    .... The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health...

  13. AAHA dental care guidelines for dogs and cats.

    Science.gov (United States)

    Holmstrom, Steven E; Bellows, Jan; Colmery, Ben; Conway, M Lana; Knutson, Kate; Vitoux, Jeanne

    2005-01-01

    The purpose of this document is to provide guidelines for the practice of companion animal dentistry for the veterinary profession. Dental care is necessary to provide optimum health and quality of life. Diseases of the oral cavity, if left untreated, are often painful and can contribute to other local or systemic diseases. This paper includes guidelines for materials and equipment, dental cleaning and evaluation, client communication, and pet home care.

  14. Preventive dental care among Medicaid-enrolled senior adults: from community to nursing facility residence.

    Science.gov (United States)

    Kelly, Mary C; Caplan, Daniel J; Bern-Klug, Mercedes; Cowen, Howard J; Cunningham-Ford, Marsha A; Marchini, Leonardo; Momany, Elizabeth T

    2017-09-08

    The primary objective of this study was to determine whether the utilization rate of preventive oral health care services while senior adults were community-dwelling differed from the rate after those same senior adults were admitted to nursing facilities. A secondary objective was to evaluate other significant predictors of receipt of preventive oral health procedures after nursing facility entry. Iowa Medicaid claims from 2007-2014 were accessed for adults who were 68+ years upon entry to a nursing facility and continuously enrolled in Medicaid for at least three years before and at least two years after admission (n = 874). Univariate, bivariate and multivariable analyses were conducted. During the five years that subjects were followed, 52.8% never received a dental exam and 75.9% never received a dental hygiene procedure. More Medicaid-enrolled senior adults received ≥1 preventive dental procedure in the two years while residing in a nursing facility compared to the three years before entry. In multivariable analyses, the strongest predictor of preventive oral health care utilization after entry was the receipt of preventive oral health services before entry (p dental procedures in the two years after nursing facility entry was the receipt of dental procedures in the three years before entry while community-dwelling. This underscores the importance of the senior adult establishing a source of dental care while community-dwelling. © 2017 American Association of Public Health Dentistry.

  15. [Users satisfaction with dental care services provided at IMSS].

    Science.gov (United States)

    Landa-Mora, Flora Evelia; Francisco-Méndez, Gustavo; Muñoz-Rodríguez, Mario

    2007-01-01

    To determine users' satisfaction with dental care services provided at Instituto Mexicano del Seguro Social in Veracruz. An epidemiological survey was conducted in 14 family medicine clinics located in the northern part of the state of Veracruz. The clinics were selected by stratified-random sampling. All users older than 20 years seeking medical or dental care services were interviewed; previously, their informed consent was obtained. We used the 6-items United Kingdom dental care satisfaction questionnaire (Spanish version) where question number four evaluates user satisfaction. From October to December 2005, 3601 users were interviewed. We excluded 279 questionnaires because the age of the interviewees was <20 years. The final analysis included 3322 interviews (92%); 73% were female with an average age of 45 +/- 16 years old. 82% were satisfied with dental care services and 91% never felt like making a complaint. Waiting time of less than 30 minutes and last visit to the dentist in the last year were the only variables related to satisfaction (p = 0.0001). There is a high level of satisfaction regarding dental care services among Mexican Institute of Social Security users. However, it would be possible to increase the level of satisfaction if the waiting time is reduced and the number of dental care users attending twice a year increases.

  16. Adults with Disabilities and Proper Dental Care

    Science.gov (United States)

    Waldman, H. Barry; Perlman, Steven P.; Cinotti, Debra A.

    2009-01-01

    Repeated studies of graduating dental students indicate limited preparation to provide services for individuals with special healthcare needs. By the end of the 1990s and into the present decade, more than half of the U.S. dental schools provided less than five hours of class room presentations and about three quarters of the schools provided 0-5…

  17. Adults with Disabilities and Proper Dental Care

    Science.gov (United States)

    Waldman, H. Barry; Perlman, Steven P.; Cinotti, Debra A.

    2009-01-01

    Repeated studies of graduating dental students indicate limited preparation to provide services for individuals with special healthcare needs. By the end of the 1990s and into the present decade, more than half of the U.S. dental schools provided less than five hours of class room presentations and about three quarters of the schools provided 0-5…

  18. Interprofessional education: the inclusion of dental hygiene in health care within the United States - a call to action.

    Science.gov (United States)

    Vanderbilt, Allison A; Isringhausen, Kim T; Bonwell, Patricia Brown

    2013-01-01

    There is a lack of access to oral health care in the United States for rural, underserved, uninsured, and low-income populations. There are widely recognized problems with the US health care system, including rapidly increasing costs and access to oral health. During the last decade, there has been a huge influx and push toward interprofessional education programs; however, these programs conveniently leave out dental hygiene. Interprofessional education can bring forth the collaboration, communication, and teamwork necessary to provide a comprehensive health care plan to treat oral health care needs in patients. As the advanced practice for dental hygiene emerges, it is imperative that the educational qualifications of dental hygienists are sufficient to enable them to safely provide the scope of services and care encompassed in these new expanded roles and to effectively participate as an interprofessional team member.

  19. Open Access to essential health care information

    Directory of Open Access Journals (Sweden)

    Pandey Manoj

    2004-12-01

    Full Text Available Abstract Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI countries in which there is currently a lack of informed health care providers – mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries.

  20. Dental care and treatment needs of elderly in nursing homes in Saarland: perceptions of the homes managers.

    Science.gov (United States)

    Rabbo, Mohammad Abed; Mitov, Gergo; Gebhart, Florian; Pospiech, Peter

    2012-06-01

    To investigate nursing home managers' perceptions and attitudes towards oral health care and access to dental services for aged care facility residents. Questionnaires containing 28 closed-ended questions were mailed to all 114 nursing homes in Saarland, Germany. Descriptive statistics were calculated for response items. Facility response rate was 39%. None of the nursing homes in this study offered systematic dental health care. Initial dental screening was carried out only in one facility. In 81%, dental examinations only took place if required. Although stationary dental equipment was available only in one home, dental treatment was carried out in 71% of the cases by a dentist in the nursing home. Eighty-four per cent of the homes' managements rated the state of the dentition of the inhabitants as satisfying. Over half of the managers indicated satisfaction with the know-how of their nursing staff concerning oral hygiene procedures. The most significant barriers to provision of dental care in the facilities according to their managers were staff shortage, lack of interest of the inhabitants and financial concerns. The results of this study showed an urgent need for estimating a programme for systematic dental care for institutionalised elder people in the federal state of Saarland. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  1. Dental education and changing oral health care needs: disparities and demands.

    Science.gov (United States)

    Albino, Judith E N; Inglehart, Marita R; Tedesco, Lisa A

    2012-01-01

    The population of the United States has changed dramatically over recent decades and, with it, the oral health care needs of the nation. Most notably, the racial/ethnic composition of the population has shifted from a European American majority to what is now a much more diverse population, comprising a variety of racial/ethnic groups that, taken together, will become the majority by mid-century. The proportion of children from minority racial groups will represent more than half of all U.S. children by 2025. These groups are overrepresented among those living below the poverty level and have higher levels of oral disease and are less likely to have access to care than the European American segment of the U.S. population. Most of the population needing dental care in the future will be comprised of these now underserved groups, along with other groups who can be described in terms of the health and social challenges of aging, disabilities, or other special health care conditions. This article provides an overview of these various needs and what they will mean for the dental practitioners of tomorrow and suggests that dental education has not adapted to the changing population and its oral health needs as quickly as it should. As a result, we identify major gaps in current dental curricula and make some recommendations for change. Research has shown that dental education has a crucial influence on future providers' professional attitudes and behavior related to providing care for patients from underserved patient groups. Acknowledging the specific needs of patients and ensuring that future providers are optimally prepared to respond to these challenges must be a major goal of dental education in the twenty-first century. The Journal of Dental Education will continue to play a critical role in informing readers about innovative approaches and best practices that ensure this goal can be met.

  2. Prevalence and Factors Associated with the Utilization of Dental Care Services among Factory Workers in Nava Nakorn Industrial Estate, Pathumthani Province, Thailand.

    Science.gov (United States)

    Jaidee, Jeeratip; Ratanasiri, Amornrat; Chatrchaiwiwatana, Supaporn; Soonthon, Surasak

    2015-07-01

    The present study aimed to find out the utilization prevalence of dental care services among factory workers over a period of one year and factors associated with utilization of dental care services. This was a cross-sectional analytic study. The study population was factory workers in Nava Nakorn Industrial Estate randomly sampled using Probability Proportion to Size Cluster Sampling Method. The tool was a questionnaire about utilization of dental care services. Among the sample group of 1,500 workers from 16 factories, almost 2/3 (63.9%) had never used any dental care services in the previous year while only 36.1% did. A multivariable logistic regression analysis showed that workplace, accommodation, tooth decay, toothache history, transportation, experience in using social security fund for dental care services, availability and accessibility of dental care services, brushing teeth regularly after meals, using dental care services regularly in a dental clinic, and agreement with the idea that a tooth extraction and medication by a dentist could reduce the risk of progression of disease, statistical significance (p-value factory workers who did not use dental care services during the last one year was 63.9 percent. This study identified three groups of factors associated with the utilization of dental care services as: 1) Predisposing factors, 2) Enabling factors, and 3) Need factors.

  3. A qualitative analysis of oral health care needs in arkansas nursing facilities: the professional role of the dental hygienist.

    Science.gov (United States)

    Hardgraves, Virginia M; Mitchell, Tanya Villalpando; Hanson, Carrie-Carter; Simmer-Beck, Melanie

    2014-12-01

    Frail elders and nursing home residents are vulnerable to poor oral health and frequently lack access to dental care. The purpose of this study was to determine why residents in Arkansas skilled nursing facilities have limited access to oral health care. This study utilized qualitative research methodology. Data was collected from oral health care personnel through open-ended responses in a written survey (n=23) and through telephone interviews (n=21). The investigators applied the constant comparative method to analyze and unitize the data and ultimately reach consensus. Data analysis resulted in consensus on 2 emergent themes: policy and access. This qualitative case study suggests access to oral health care for residents living in both long-term care (LTC) and assisted living I and II facilities in Arkansas is affected by public and facility policies and access to oral health care as a function of the patient's health status and availability of oral health care providers. Access for residents residing in assisted living I and II facilities is also limited by the residents' inability to assume responsibility for accessing oral health care. The outcomes from this study may serve to inform policymakers and advocates for access to oral health care as they develop new policies to address this growing need. Copyright © 2014 The American Dental Hygienists’ Association.

  4. Estimated Costs of Dental Care due to Dental Decay in Mexican High School Students

    OpenAIRE

    2010-01-01

    Objective: Estimate the cost of dental care generated by the dental decay prevalence in high school students at Universidad Nacional Autónoma de México (UNAM). Methods: A cross-sectional study was carried out with a population of 78,870 high schoolers (conducted between the years 2003 and 2005). The need for dental caries treatment was determined by the decayed, missing and filled teeth index (DMFT) as it is indicated at the Automated Medical Exam (EMA, acronym in Spanish). The estimation of ...

  5. Does Smoking Hamper Oral Self-Care Among Dental Professionals?

    Directory of Open Access Journals (Sweden)

    Hadi Ghasemi

    2015-10-01

    Full Text Available Objectives: Smoking may impact oral self-care (OSC.  This study aimed to analyze the role of smoking in OSC among Iranian dental health professionals.Materials and Methods: The cross-sectional data were collected at two annual dental meetings and seven randomly selected dental schools in Iran. A total of 1,459 respond- ents composed of 967 general dental practitioners (GDPs, 229 dental educators (DE, and 263 senior dental students (DS anonymously completed a self-administered ques- tionnaire inquiring about smoking status and OSC.Results: Thirty percent of the men and 12% of women reported smoking with no dif-ference according to their professional status. Women reported better OSC than did men, but only 26% of the women and 17% of the men followed the three most important recommendations for OSC. Smoking was associated with infrequent tooth brushing and flossing, irregular use of fluoride containing toothpaste, consumption of sugary snacks, and weak adherence to the recommended OSC guidelines.Conclusion: Dental health education should place more emphasis on smoking counsel-ing and cessation among dental health professionals.

  6. Cost differentials of dental outpatient care across clinical dentistry branches

    OpenAIRE

    Jovana Rančić; Nemanja Rančić; Nemanja Majstorović; Vladimir Biočanin; Marko Milosavljević; Mihajlo Jakovljević

    2015-01-01

    Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was...

  7. Oral health care for children in countries using dental therapists in public, school-based programs, contrasted with that of the United States, using dentists in a private practice model.

    Science.gov (United States)

    Mathu-Muju, Kavita R; Friedman, Jay W; Nash, David A

    2013-09-01

    The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children's access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, "A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States." We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices.

  8. Interprofessional education: the inclusion of dental hygiene in health care within the United States – a call to action

    Directory of Open Access Journals (Sweden)

    Vanderbilt AA

    2013-10-01

    Full Text Available Allison A Vanderbilt,1 Kim T Isringhausen,2 Patricia Brown Bonwell2,3 1Center on Health Disparities and School of Medicine, 2Department of Oral Health Promotion and Community Outreach, School of Dentistry, 3Dental Hygiene Program, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA Abstract: There is a lack of access to oral health care in the United States for rural, underserved, uninsured, and low-income populations. There are widely recognized problems with the US health care system, including rapidly increasing costs and access to oral health. During the last decade, there has been a huge influx and push toward interprofessional education programs; however, these programs conveniently leave out dental hygiene. Interprofessional education can bring forth the collaboration, communication, and teamwork necessary to provide a comprehensive health care plan to treat oral health care needs in patients. As the advanced practice for dental hygiene emerges, it is imperative that the educational qualifications of dental hygienists are sufficient to enable them to safely provide the scope of services and care encompassed in these new expanded roles and to effectively participate as an interprofessional team member. Keywords: interprofessional education, dental hygiene programs, dental hygiene education, oral health education

  9. Dental Education Required for the Changing Health Care Environment.

    Science.gov (United States)

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  10. Leadership theory: implications for developing dental surgeons in primary care?

    Science.gov (United States)

    Willcocks, S

    2011-02-12

    The development of leadership in healthcare has been seen as important in recent years, particularly at the clinical level. There have been various specific initiatives focusing on the development of leadership for doctors, nurses and other health care professions: for example, a leadership competency framework for doctors, the LEO programme and the RCN clinical leadership programme for nurses. The NHS has set up a Leadership Council to coordinate further developments. However, there has not been the same focus in dentistry, although the recent review of NHS dental services (Steele review) has proposed a need for leadership initiatives in NHS dentistry as a medium-term action. Central to this will be a need to focus on the leadership role for dental surgeons. Leadership is all the more important in dentistry, given the change of government and the policy of retrenchment, major public sector reform, the emergence of new organisations such as new commissioning consortia, possible changes to the dental contract, new ways of working, and changes to the profession such as the requirements for the revalidation of dental surgeons. The question is: which leadership theory or approach is best for dental surgeons working in primary care? This paper builds on earlier work exploring this question in relation to doctors generally, and GPs, in particular, and planned work on nurses. It will seek to address this question in relation to dental surgeons working in primary care.

  11. Dental care in children with developmental disabilities: attention deficit disorder, intellectual disabilities, and autism.

    Science.gov (United States)

    Charles, Jane M

    2010-01-01

    The Federal government reports that 13% of Americans between birth and 18 years of old meet the definition of a child with special health care needs. These children and young adults present unique challenges for both pediatric and general dentists to provide access to the oral health care system--establishing a treatment plan for those with unique medical, behavioral and dental needs and maintaining oral health over the lifetime. The purpose of this article was to describe the characteristics of 3 common developmental disabilities and the challenges these issues present to the oral health care practitioner.

  12. Dental education and care for underserved patients: an analysis of students' intentions and alumni behavior.

    Science.gov (United States)

    Smith, Carlos S; Ester, Todd V; Inglehart, Marita Rohr

    2006-04-01

    The U.S. surgeon general's report on oral health stressed the importance of providing dental care to underserved patients. The objectives of this study were to explore a) dental students' intentions and dentists' behavior concerning treating underserved patients, b) their perceptions of their education concerning these patients, and c) the relationship between dental education and their attitudes and behavior. Data were collected from 328 dental students (response rate: 77.5 percent) and 234 alumni (response rate: 43.7 percent). Only 67.4 percent of the students and 38 percent of the alumni indicated that their education had prepared them well to treat patients from different socioeconomic backgrounds; 71.3 percent of students and 55.2 percent of alumni responded that they had been well educated to treat patients from different ethnic/racial groups. The findings showed a positive relationship between the degree of curriculum focus on the importance of treating patients from all aspects of society and students' and alumni intentions to provide inclusive patient care to patients from diverse backgrounds. The more students agreed that their dental education had prepared them well to treat patients from different ethnic backgrounds, the more likely they were to report that they intended to treat these patients (r=.12; p=.033). In a similar manner, the more the alumni agreed that their dental education had prepared them well to treat patients in different communities, the more likely they were to treat patients from different socioeconomic backgrounds (r=.18; p=.009). In conclusion, these findings showed that access to oral health care for underserved patients could potentially be increased if dental students were more overtly educated about the importance of treating patients from all segments of society.

  13. Maternal Health Care Services Access Index and Infant Survival in

    African Journals Online (AJOL)

    GB

    ... reduce in Nigeria. KEYWORDS: Infant mortality, Maternal health care, Pregnancy care, Delivery care, Nigeria ... not go for antenatal care, and as a result may not access other cares ...... Inadequate Use of Prenatal Services Among. Brazilian ...

  14. Dementia prevalence, care arrangement, and access to care in Lebanon

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Chaaya, Monique; Prince, Martin

    2017-01-01

    INTRODUCTION: In North Africa and the Middle East, studies about dementia prevalence are scarce. A pilot study was conducted in Lebanon to assess dementia prevalence, using the Arabic-validated 10/66 Dementia Research Group (DRG) diagnostic assessment for case ascertainment. The study also examined...... care arrangement and access to care. METHODS: A random sample of 502 persons older than 65 years and their informant were recruited from Beirut and Mount Lebanon governorates through multistage cluster sampling. RESULTS: The crude and age-standardized dementia prevalences were 7.4% and 9.......0%, respectively. People with dementia were mainly cared for by relatives at home. Access to formal care was very limited. DISCUSSION: Dementia prevalence in Lebanon ranks high within the global range of estimates. These first evidence-based data about disease burden and barriers to care serve to raise awareness...

  15. INTRODUCTION Dental care utilization can be defined as the ...

    African Journals Online (AJOL)

    of the population who access dental services over a specified period of ... problem with universal distribution and affecting all age ... The younger age groups were noticed to be more ..... income African-American children: J.Am Dent Ass. 2007 ...

  16. Accessing diabetes care in rural Uganda

    DEFF Research Database (Denmark)

    Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.

    2017-01-01

    Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited......, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes...... to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients’ journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more...

  17. A first look: determinants of dental care for children in foster care.

    Science.gov (United States)

    Melbye, M; Huebner, C E; Chi, D L; Hinderberger, H; Milgrom, P

    2013-01-01

    This hypothesis-generating study sought to identify potential determinants of dental care use and oral health among children living in foster care. Using a grounded theory approach, fourteen key informant interviews were conducted among health and social services professionals experienced with children in foster care and families in western Washington State. The identified potential determinants of oral health and dental use among children living in foster care included: (1) linguistic and cultural barriers; (2) lack of dentists willing to accept children's Medicaid dental insurance; (3) lack of resources available to case workers (i.e., large caseload burden) (4) lack of federal funding for specialized dental care; (5) lack of systematic health record-keeping; (6) child transience, leading to the lack of a dental home; (8) foster parents' competing needs; (7) child behavior problems; and (9) lack of dental "buy in" from adolescents. Additional studies are needed to determine whether children living in foster care achieve oral health, and the extent of their unmet dental need. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  18. 2013 AAHA dental care guidelines for dogs and cats.

    Science.gov (United States)

    Holmstrom, Steven E; Bellows, Jan; Juriga, Stephen; Knutson, Kate; Niemiec, Brook A; Perrone, Jeanne

    2013-01-01

    Veterinary dentistry is constantly progressing. The purpose of this document is to provide guidelines for the practice of companion animal dentistry for the veterinary profession. Dental care is necessary to provide optimum health and optimize quality of life. Untreated diseases of the oral cavity are painful and can contribute to local and systemic diseases. This article includes guidelines for preventive oral health care, client communication, evaluation, dental cleaning, and treatment. In addition, materials and equipment necessary to perform a medically appropriate procedure are described.

  19. Integrating child dental care at Community Smiles: the director's goals fulfilled....

    Science.gov (United States)

    Flaer, Paul J; Benjamin, Paul L; Lopez, Manuel G; Patterson, Chip

    2010-01-01

    Community Smiles/Dade County Dental Research Clinic provides dental care to the indigent population of Miami-Dade County. A local board of directors governs the organization, with dental procedures performed by volunteer professionals from the community. The research clinic partners with community organizations to obtain sustained funding from diverse sources. The clinic has a long-term commitment to the growth and development of children in the community. Certainly, changing the structure and focus of the clinic toward children's dental care and seeking community funding and resources to institute this program was an experiment. In his four years as clinic director and chief executive officer (CEO) at Community Smiles, the late Dr. Robert M. Wolf brought increased clinic productivity and organizational change that expanded community involvement. Dr. Wolf's tenure at Community Smiles brought general increases in patients care in terms of patients visits, new patients and number of procedures performed. However, the key to his administration as clinic director and CEO was the production and integration of a children's dentistry program into the mainstream activities of the clinic. Furthermore, he oversaw the successful corporate reorganization of Community Smiles as the clinic emerged under a non-profit corporate structure employing multi-faceted community resources. Emphasizing new dental programs for children in the community is culturally and socially competent--positively impacting the public health. Community Smiles became a venue where disparities were largely eliminated and access to dental treatment increased. Health care was promoted as Community Smiles became a place that helped build a healthier community.

  20. Rheumatoid arthritis: a review and dental care considerations.

    Science.gov (United States)

    Grover, H S; Gaba, N; Gupta, A; Marya, C M

    2011-06-01

    Rheumatoid arthritis (RA), is a chronic multisystem disease of presumed autoimmune etiology. Medical complications due to RA and its treatment may affect the provision of oral health care. Associated syndromes may contribute to a patient's susceptibility to infections and impaired hemostasis. Therefore oral health care providers need to recognize and identify modificationsof dental care based on the medical status of patients with RA. As with many other chronic conditions, early intervention can reduce the severity of the disease. Furthermore, oral health care providers play an important role in the overall care of these patients as it relates to early recognition, as well as control of the disease.

  1. The Influence of Changes in Dental Care Coverage on Dental Care Utilization Among Retirees and Near-Retirees in the United States, 2004–2006

    Science.gov (United States)

    Moeller, John F.; St Clair, Patricia A.; Schimmel, Jody; Chen, Haiyan; Pepper, John V.

    2011-01-01

    Objectives. We examined dental care utilization transition dynamics between 2004 and 2006 in the context of changing dental coverage status. Methods. We used data from the Health and Retirement Study for persons aged 51 years and older to estimate a multivariable model of dental care use transitions with controls for dental coverage and retirement transitions and other potentially confounding covariates. Results. We found that Americans aged 51 years and older who lost dental coverage between the 2004 and 2006 survey periods were more likely to stop dental care use between periods, and those who gained coverage were more likely to start dental care use between periods, than those without coverage in both periods. Conclusions. Dental coverage transitions and status have a strong effect on transitions in dental care use. Given that retirement is a time when many experience a loss of dental coverage, older adults may be at risk for sporadic dental care and even stopping use, leading to worse dental and potentially overall health. PMID:21852656

  2. Access and care issues in urban urgent care clinic patients

    Directory of Open Access Journals (Sweden)

    Adams Jill C

    2009-12-01

    Full Text Available Abstract Background Although primary care should be the cornerstone of medical practice, inappropriate use of urgent care for non-urgent patients is a growing problem that has significant economic and healthcare consequences. The characteristics of patients who choose the urgent care setting, as well as the reasoning behind their decisions, is not well established. The purpose of this study was to determine the motivation behind, and characteristics of, adult patients who choose to access health care in our urgent care clinic. The relevance of understanding the motivation driving this patient population is especially pertinent given recent trends towards universal healthcare and the unclear impact it may have on the demands of urgent care. Methods We conducted a cross-sectional survey of patients seeking care at an urgent care clinic (UCC within a large acute care safety-net urban hospital over a six-week period. Survey data included demographics, social and economic information, reasons that patients chose a UCC, previous primary care exposure, reasons for delaying care, and preventive care needs. Results A total of 1, 006 patients were randomly surveyed. Twenty-five percent of patients identified Spanish as their preferred language. Fifty-four percent of patients reported choosing the UCC due to not having to make an appointment, 51.2% because it was convenient, 43.9% because of same day test results, 42.7% because of ability to get same-day medications and 15.1% because co-payment was not mandatory. Lack of a regular physician was reported by 67.9% of patients and 57.2% lacked a regular source of care. Patients reported delaying access to care for a variety of reasons. Conclusion Despite a common belief that patients seek care in the urgent care setting primarily for economic reasons, this study suggests that patients choose the urgent care setting based largely on convenience and more timely care. This information is especially applicable to

  3. Dental health of Spanish children: an investigation in primary care.

    Science.gov (United States)

    Turabián, J L; de Juanes, J R

    1990-03-01

    The oral hygiene of patients between seven and 14 years old from a health centre in Toledo was studied through case-finding from March to December 1987. A total of 304 interviews were held; bad dental care (frequency of teeth brushing with fluoride toothpaste less than once per day and/or daily consumption of chocolate and sweets) was found in 83%, and caries were diagnosed through inspection in 92% of the patients. Seventy three per cent reported washing their teeth only occasionally or never; 40% consumed sweets daily; 53% had never visited the dentist; and 50% had not received preventive care for dental disease. These results contrast with those from the United Kingdom and other developed countries, indicating a precarious state of dental health in Spain, a fact which should be taken into account by the Spanish health organization when comparing the health levels between different countries.

  4. Occupational safety among dental health-care workers

    Directory of Open Access Journals (Sweden)

    Shigehiro Shimoji

    2010-10-01

    Full Text Available Shigehiro Shimoji1, Kohji Ishihama1,2, Hidefumi Yamada1, Masaki Okayama1, Kouichi Yasuda1,3, Tohru Shibutani3,4, Tadashi Ogasawara2,5, Hiroo Miyazawa2,3, Kiyofumi Furusawa11Department of Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Japan; 2Infection Control Team, 3Risk Management Working Team, Matsumoto Dental University Hospital, Shiojiri, Japan; 4Department of Dental Anesthesiology, 5Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, JapanAbstract: Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%, 6 splash exposures (18.8%, and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66 reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58 and 60.3% (35/58 in dentists and 88.6% (39/44 and 61.4% (27/44 in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58 for dentists and 34.1% (15/44 for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were ‘splatters from the patient’s mouth contain blood

  5. Factor analysis on implementation of domiciliary dental care in Metropolitan Tokyo.

    Science.gov (United States)

    Hirata, SoIchiro; Sakayori, Takaharu; Maki, Yoshinobu; Takano, Naohisa; Ishii, Takuo

    2013-01-01

    The need for domiciliary dental care has increased with the aging of Japanese society. The Tokyo Metropolitan Government and Tokyo Dental Association conducted a survey of dental institutions within Tokyo in order to clarify which factors influenced implementation of domiciliary dental care by dental institutions. The proportion was significantly higher in (1) dentists in their 50s or older, (2) those working in cooperation with primary care physicians, (3) those providing dysphagia rehabilitation, (4) those who give information on prevention of aspiration pneumonia, (5) those who attended training on medical or domiciliary dental care for the elderly in need of nursing care, and (6) those who attended training workshops and seminars provided by the Tokyo Dental Association in 2010. In the logistic regression analysis, a significant odds ratio was obtained for the same items, excluding age. Attendance at training on medical or domiciliary dental care for the elderly in need of nursing care had the highest odds ratio. Those who attended any kind of training course implemented domiciliary dental care significantly more often. Training conducted by the Tokyo Metropolitan Center for Oral Health of Persons with Disabilities, Tokyo Dental Association, and local dental associations showed a significant odds ratio, with the highest by the Tokyo Dental Association. Traditionally, education on domiciliary dental care in the elderly is not provided at the college level. The present results indicate the importance of educating students with regard to the unique challenges such work poses. Attending seminars hosted by the Tokyo Dental Association also significantly influenced implementation of domiciliary dental care. This seems to be an important result, suggesting the effectiveness of training provided by dental associations with regard to the promotion of domiciliary dental care. This indicates the need for dental associations to provide such training throughout Japan.

  6. Representation of dental care and oral health in children's drawings.

    Science.gov (United States)

    Torriani, D D; Goettems, M L; Cademartori, M G; Fernandez, R R; Bussoletti, D M

    2014-06-01

    Paediatric dentistry requires knowledge of preventive measures, restorative skills and an understanding of child development. This exploratory, descriptive and qualitative study has analysed children's drawings regarding their perception of dental treatment and oral health. Children aged from six to ten years attending a dental school for treatment were randomly invited to create a drawing about 'dental treatment' and 'oral health'. Verbal expressions made by the children whilst drawing were also recorded and attached to the drawings. These representations were analysed and categorised using Vygotsky postulations for context reading. During the drawing analysis different themes emerged. Five categories regarding perceptions of dental treatment were identified: personal relationship; power relation; trauma; childhood resistance; and contextualisation of dental care in the child's life. Three categories relating to oral health were determined: dichotomy of health/sickness; ludic representation of health; and sickness seen as a process. Drawing can be used to understand children's emotions and expectations about dental treatment. Besides possessing technical skills and scientific knowledge, dentists have an obligation to pay attention to children's feelings.

  7. Investing in Preventive Dental Care for the Medicare Population: A Preliminary Analysis

    Science.gov (United States)

    Moeller, John F.; Chen, Haiyan

    2010-01-01

    Objectives. We estimated the use of preventive dental care services by the US Medicare population, and we assessed whether money spent on preventive dental care resulted in less money being spent on expensive nonpreventive procedures. Methods. We used data from the 2002 Medicare Current Beneficiary Survey to estimate a multinomial logistic model to analyze the influence of predisposing, enabling, and need variables in identifying those beneficiaries who used preventive dental care, only nonpreventive dental care, or no dental care in a multiple-variable context. We used regression models with similar controls to estimate the influence of preventive care on the utilization and cost of nonpreventive dental care and all dental care. Results. Our analyses showed that beneficiaries who used preventive dental care had more dental visits but fewer visits for expensive nonpreventive procedures and lower dental expenses than beneficiaries who saw the dentist only for treatment of oral problems. Conclusions. Adding dental coverage for preventive care to Medicare could pay off in terms of both improving the oral health of the elderly population and limiting the costs of expensive nonpreventive dental care for the dentate beneficiary population. PMID:20864712

  8. Measuring quality of dental care: Caries prevention services for children.

    Science.gov (United States)

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  9. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    Science.gov (United States)

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p < .012) in young adulthood. Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Cost differentials of dental outpatient care across clinical dentistry branches

    Directory of Open Access Journals (Sweden)

    Jovana Rančić

    2015-03-01

    Full Text Available Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was adopted. Sample size was 752 complete episodes of treatment in 250 patients, selected in 2012/2013 throughout several specialist state- and private-owned dental clinics in Serbia. All direct costs of dental care were taken into account and expressed in Euros (€.Results: Mean total costs of dental care were € 46 ± 156 per single dentist visit while total costs incurred by this population sample were € 34,424. Highest unit utilization of services belongs to conservative dentistry (31.9%, oral surgery (19.5% and radiology (17.4%, while the resource with the highest monetary value belongs to implantology € 828 ± 392, orthodontics € 706 ± 667 and prosthetics € 555 ± 244. The most frequently treated diagnosis was tooth decay (33.8% unit services provided, pulpitis (11.2% and impacted teeth (8.5%, while most expensive to treat were anomalies of tooth position (€ 648 ± 667, abnormalities of size and form of teeth (€ 508 ± 705 and loss of teeth due to accident, extraction or local periodontal disease (€ 336 ± 339.Conclusion: Although the range of dental costs currently falls behind EU average, Serbia’s emerging economy is likely to expand in the long run while market demand for dental services will grow. Due to threatened financial sustainability of current health insurance patterns in Western Balkans, getting acquainted with true size and structure of dental care costs could essentially support informed decision making in future

  11. Ethical Considerations In Dental Care For People With Developmental Disabilities

    Directory of Open Access Journals (Sweden)

    Biris Carmen

    2016-06-01

    Full Text Available Developmental disabilities exist in children and adolescents, enabling them to live an independent and self-governing life, requiring special health related services. We are intended to inform dental professionals in planning and implementing a dental treatment for people with developmental disabilities. Cerebral palsy is defined as being a group of motor abnormalities and functional impairments that affect muscle coordination, and characterized by uncontrolled body movements, intellectual disabilities, balance-related abnormalities or seizure disorders. These patients can be successfully treated in normal dental practices, but because they have problems with movements, care must be tailored accordingly. Down syndrome, a very common genetic disorder, is usually associated with different physical and medical problems, intellectual disabilities, and a developmental delay. These patients can be treated with success in dental offices, this way making a difference in the medical care for people with special needs. Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication and by restricted and repetitive behavior. Self-injurious behavior, obsessive routines and unpredictable body movements can influence dental care. Because of the coexisting conditions (epilepsy or intellectual disability, one can find this people among the most challenging to treat. There is a need of greater awareness, focus and education in the field of the unique and complex oral health care that people with disabilities need. Making a difference their oral health positively influences an already challenged existence. According to the ethical principles, patients with developmental disabilities should be treated equitably depending on their necessities.

  12. Access to care for people with special needs: role of alternative providers and practice settings.

    Science.gov (United States)

    Miller, Christine E

    2005-09-01

    Oral Health in America: A Report of the Surgeon General released in 2000 was the first-ever surgeon general's report on the status of oral health in the United States. It clearly outlined a growing set of challenges in such areas as reducing oral health disparities, improving access to oral and dental care, and prevention of common dental diseases. Findings revealed that 75 percent of dental disease is found in 25 percent of the population. California's children have twice as much untreated decay as their national counterparts. For children with special health care needs seeing a dentist, the data is sparse but a survey of general dentists conducted in 2001 showed that only 10 percent see these children often or very often.

  13. Epilepsy in the dental office: concern, care and management.

    Science.gov (United States)

    Haller, Jerome S

    2008-04-01

    Epilepsy, also known as seizure disorder, encompasses several different modes of presentation. Patients of all ages, from early childhood to the elderly, who present for dental care may be taking anticonvulsants or may have an unanticipated seizure in the dental office. Dentists should be familiar with the varied manifestations of seizures, the medications used in their treatment and management of a seizure in the dental office. It is estimated that 1% of the population of the United States are afflicted with epilepsy. There is indication that the elderly are becoming included in that number because of their affliction with cardiovascular disorders. The word "epilepsy" raises anxiety in many people because they fear that such an event is life threatening. However, the term epilepsy applies primarily to prolonged or repetitive seizures requiring intervention by trained individuals.

  14. Occupational safety among dental health-care workers.

    Science.gov (United States)

    Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

    2010-01-01

    Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were 'splatters from the patient's mouth contain blood' (90%, 99/110) and 'dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV' (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment.

  15. Cruise medicine: the dental perspective on health care for passengers during a world cruise.

    Science.gov (United States)

    Sobotta, Bernhard A J; John, Mike T; Nitschke, Ina

    2008-01-01

    Although more than 100 million passengers have taken a cruise since 1980, it is not known what dental treatment needs occur at sea. The routine dental documentation of a 2-month period at sea on a cruise ship carrying 1,619 passengers was analyzed. The subjects for the study were 57 passengers (3.5% of 1,619), with a mean age of 71 years (+/-9.8 y). Age, gender, number of natural teeth and implants, prosthetic status, diagnosis, treatment performed, percentage of emergency and routine procedures, number of appointments, duration of appointment, time since last visit to the dentist, and cabin category as indicator of socioeconomic status were extracted. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile. Passengers had a mean number of 20 natural teeth plus substantial fixed and removable prosthodontics. Emergency dental treatment accounted for 97% of the chairside time. The three most frequent emergency diagnoses were defective restorations (36%), pulpal disease (20%), and defective prosthesis and caries (both 11.5%). Common emergency therapies provided were complex surgical-prosthodontic rehabilitation, various endodontic treatments, and extractions. Per 1,000 persons/month, passengers required 21.6 emergency plus 2.5 routine appointments; 49% of passengers had seen a dentist within 3 months before going to sea. Passengers do attend their dentist for routine care/checkups before the voyage, yet experience complex dental emergencies. This is due to the presence of a high number of restorations that fail unexpectedly. Some failures are so severe that they would have forced the passenger to abort the cruise had there been no dental service available. The ease of access to quality dental care may explain the relatively low level of perceived problems as characterized by OHRQoL scores.

  16. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Directory of Open Access Journals (Sweden)

    Savanheimo Nora

    2012-10-01

    Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.

  17. DENTAL CARE FOR CHILDREN AFTER REPLANTATION OF AVULSED PERMANENT INCISORS

    Directory of Open Access Journals (Sweden)

    Rossitza Kabaktchieva

    2016-12-01

    Full Text Available The diagnosis avulsion of permanent tooth/teeth is an emergency situation which has special requirements in respect of proper storage of the avulsed tooth, the need of urgent medical/dental care, time past till replantation and splinting, the need for endodontic treatment and long term follow up period. Those clinical actions depend on three groups: parents/people who are with the child in the moment when trauma happens and give the first aid; dental specialist- surgeon who replants the tooth/teeth; dental specialist- endodontist who takes care of the endodontic treatment and the long period after treatment for follow up and observation of the replanted teeth. The aim of the paper is to present the dental postoperative care in a couple of cases of children with trauma and replanted avulsed permanent incisors. Material and methods: We present four clinical cases of children who get 6 permanent upper incisors replanted. Replantation is made by the oral surgeon. Treatment and observation after replantation are made by dental specialists of pediatric dentistry and conservative dentistry. All 4 cases get 3 years follow up period. Results: After replantation of 2 central incisors with complete root development (first clinical case the left one has developed a resorption of the root but the right one is in a stable condition. Replantation of 3 teeth with incomplete root development (second and third clinical cases where the patients refer to specialized surgical care less than 60 minutes after injury and store the teeth in different ways lead to different clinical results. In the case of avulsed upper right incisor (second case, it is stored in milk and we observe revascularization followed by partial root canal obliteration. The tooth is scheduled for endodontic treatment. In the case of upper central incisors, both kept dry till replantation in the alveolus filled up with substitute bone, we observe fast root resorption which going to lead to early

  18. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1... National Health Service Corps (NHSC) personnel to provide primary care, dental, or mental health...

  19. A student's perspective on the ethics of international charity dental care.

    Science.gov (United States)

    Bohnert, Malorie

    2014-01-01

    A senior dental student describes the deep sense of personal satisfaction from participating in a weeklong charity dental care trips to the Dominican Republic. Care, primarily consisting of extractions, was provided to individuals living in conditions that encourage dental disease at the same time the availability of oral healthcare services are essentially nonexistent.

  20. The Motivation-Facilitation Theory of Prenatal Care Access.

    Science.gov (United States)

    Phillippi, Julia C; Roman, Marian W

    2013-01-01

    Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care. © 2013 by the American College of Nurse‐Midwives.

  1. Time series analysis of dental care procedures in Brazilian public services, 1994-2007

    National Research Council Canada - National Science Library

    Roger Keller Celeste; Jacqueline Furtado Vital; Washington Leite Junger; Michael Eduardo Reichenheim

    2011-01-01

      The objectives of this study were to describe the time series of monthly rates of five dental care procedures in the Brazilian public health system and to assess changes in trends of dental procedures from 1994 to 2007...

  2. An overview of the distribution of dental care facilities in Mangalore taluk, India.

    Directory of Open Access Journals (Sweden)

    Rekha Prashanth Shenoy

    2015-09-01

    Full Text Available Objective: Equitable distribution of health care facilities is a guiding principle of Primary Heath Care. Although Mangalore taluk is a reputed center for medical education and health care, location of these facilities has not been evaluated to date. Therefore, a systematic survey was conducted to evaluate distribution of dental care facilities in Mangalore taluk, India. Material and Methods: List of Primary Health Centers, Community Health Centers and government hospitals, and details of the dental personnel and dental care facilities available at these centers was obtained from the District Health Officer (DHO. Data on registered private dental practitioners was obtained from the DHO and the Indian Dental Association. Information was obtained from dental colleges in the taluk regarding outreach activities and collaborations with the public sector. Descriptive statistics were used for data analysis. Results: Dentists are posted only at the CHCs and the District Hospital where they provide only basic dental services due to a lack of infrastructure. Of the 189 private dental clinics, 91% are located in urban areas of the taluk. They provide all modalities of dental care but are inaccessible to a majority of the rural population. Dental schools provide dental services to people in their vicinity, conduct outreach camps and have adopted four PHCs. Conclusion: An uneven distribution of dental care facilities exists with an overwhelming majority concentrated in the urban areas of the taluk. [J Contemp Med 2015; 5(3.000: 163-166

  3. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    Science.gov (United States)

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  4. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    Science.gov (United States)

    Wanyonyi, Kristina L; Radford, David R; Gallagher, Jennifer E

    2017-01-01

    This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (dental service and show that individual and contextual factors predict common treatments received. Implications of this research include the importance of making provision for our aging population and ensuring that preventative care is available to all. Further research is required to explain the interaction of organisational and system policies, practitioner and patient perspectives on care and, thus, inform effective commissioning and provision of dental services.

  5. DENTAL CARE AND CHILDREN WITH SPECIAL HEALTH CARE NEEDS: A POPULATION-BASED PERSPECTIVE

    OpenAIRE

    Lewis, Charlotte W.

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health since the Surgeon General's Report (SGR) on Oral Health. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006-National Survey of CSHCN to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to ...

  6. A land untouched by dentistry - singapore brings dental care to afghanistan.

    Science.gov (United States)

    Tan, Peng Hui; Chew, Bertrand; Wee, Wee Chee; Tan, Bernard

    2011-01-01

    In 2007, the Singapore Armed Forces deployed a Dental Project Team (DPT) to the capital city of the Bamiyan Province in Afghanistan. The team set up the province's first modern dental facility. Besides providing primary dental care to the 60,000 population there, the Singaporeans also trained and prepared a team of Afghan dentist and dental assistants. The Afghan dental team took over the dental clinic and continued to provide care when it was time for the DPT to depart for home. Braving challenging security and austere living conditions, the DPT completed its mission successfully.

  7. A political economic theory of the dental care market.

    Science.gov (United States)

    Lipscomb, J; Douglass, C W

    1982-01-01

    A theory of the dental care market is introduced which proposes that the vertically integrated (local/state/national) structure of the profession services as an organizational vehicle both for intra-professional debate and for developing provider-oriented dental care policy. We suggest that a special relationship exists between professionalism and professional regulation. Such regulation has functioned simultaneously to limit competition and to foster a prized consumption commodity for providers: professionalism and professional esteem. The organized pursuit of this commodity inherently dampens competition. Professionalism itself plays a crucial role in: 1) securing for organized dentistry a form of state regulation in which the providers themselves are the principal decision-makers; and 2) influencing provider and consumer market behavior in several significant respects, the net result being the formation of maintenance of a type of "leadership cartel" in the local market. Thus, a political-economic theory of the dental care market formally acknowledges professionalism as valued by established dentists and recent graduates as a central determining influence. Traditional models of pure competition and monopoly emerge as special, extreme cases of the general theory. Hypotheses are offered regarding consumer and provider behavior, market dynamics, and health policy and regulation. PMID:7091455

  8. Patterns of dental services and factors that influence dental services among 64-65 year-old regular users of dental care in Denmark

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Rosing, Kasper; Merete Lempert, Susanne

    2016-01-01

    OBJECTIVES: To describe the pattern of dental services provided to 64-65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related......-sectional study of all aged 64-65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public...... and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services....

  9. Oral Care in the Long-Term Care of Older Patients: How Can the Dental Hygienist Meet the Need?

    Science.gov (United States)

    Dahm, Tracee S; Bruhn, Ann; LeMaster, Margaret

    2015-08-01

    It is estimated that the older population, aged 65 and older, will make up over 20% of the U.S. population by the year 2030. Research acknowledges about 4% of the older population resides in long-term care facilities (LTCFs), where the long-term older patient (LTOP) is under the formal supervised care or custody of institutions with skilled nurses. By the year 2040, 4 million geriatric residents are predicted to move into LTCFs in the U.S. In 2000, the Surgeon General reported LTOPs in LTCFs have greater oral hygiene needs than any other segment of the population to include: root caries, periodontal disease, xerostomia, fungal infections and other oral health concerns. Serious systemic health conditions occurring at high incidence rates have been linked to poor oral hygiene in the LTOP. The purpose of this manuscript is to identify systemic health conditions, oral health conditions, barriers to oral care for LTOPs and to offer recommendations for increased access to care within LTCFs through the use of registered dental hygienists (RDHs). Copyright © 2015 The American Dental Hygienists’ Association.

  10. A new approach to ensuring oral health care for people living with HIV/AIDS: the dental case manager.

    Science.gov (United States)

    Lemay, Celeste A; Cashman, Suzanne B; McDonald, Anne; Graves, John R

    2012-01-01

    The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health. We used a qualitative descriptive study design and focus groups. Twenty-five people who had received DCM services on Cape Cod, Massachusetts, attended 1 of 5 focus groups in 2009 and 2010. Digital recordings of the groups were transcribed verbatim. Textual data were categorized using directed qualitative content analysis techniques. We identified major themes and representative quotes. The following themes emerged from discussions on the DCM's role: being available, knowledgeable about clients and insurance, and empathetic; increasing access; and providing comfort. Most participants credited their oral and overall health improvements to the DCM. All participants believed that the DCM was a valuable addition to the clinic and noted that other at-risk populations, including the elderly and developmentally disabled, likely would benefit from working with a DCM. The addition of a DCM facilitated access to dental care among this sample of people living with HIV/AIDS, providing them with an advocate and resulting in self-reported improvements to oral and overall health.

  11. Ethics as an important determinant of success of orthopaedic dental care for debilitated and elderly patients.

    Science.gov (United States)

    Schwartzseid, E E

    1989-01-01

    Ethical aspects of orthopaedic dental care for debilitated and elderly patients--the most complex and the least studied aspects of dentistry--are discussed here. Many articles on dental ethics, as a rule, do not cover the essential ethical aspects of orthopaedic care for the elderly or cover them only partially without reflecting on the problem at large. Understanding of the problem may help to provide more efficient dental care for the elderly population thus improving their quality of life.

  12. Performance indicators used to assess the quality of primary dental care.

    NARCIS (Netherlands)

    Gonzalez, G.Z.; Klazinga, N.; Asbroek, G. ten; Delnoij, D.M.

    2006-01-01

    An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. OBJECTIVES: To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a hea

  13. Oral health status of children with special health care needs receiving dental treatment under general anesthesia at the dental clinic of Taipei Veterans General Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Chia-Yu Chen

    2014-04-01

    Conclusion: Unmet dental needs and caries experience indices remain high in CSHCN, regardless of the types and severity of disability. However, the younger the age at which CSHCN received their first dental treatment, the more effective the dental rehabilitation was. Parental education regarding early dental intervention and a preventive approach for enhanced oral care is mandatory.

  14. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... dental health professional shortage areas (HPSAs) as of May 11, 2013, available on the Health Resources... assignment of National Health Service Corps (NHSC) personnel to provide primary care, ] dental, or...

  15. Stimulating the demand for dental care: An application of Ajzen and Fishbein's theory of reasoned action.

    NARCIS (Netherlands)

    Hoogstraten, J.; de Haan, W.; ter Horst, G.

    1985-01-01

    Applied I. Ajzen and M. Fishbein's (1980) attitude-behavior model to the problem of stimulating the demand for dental care with 329 members (aged 21-50 yrs) of health insurance companies who had not received regular dental treatment and/or certificate of dental fitness for at least 2 1/2 yrs. Applyi

  16. Dental care for the homeless over Christmas 1990.

    Science.gov (United States)

    Daly, B

    1991-11-23

    Each year since 1970, the charity CRISIS has provided a place of warmth and shelter for the homeless of London (guests) over the Christmas period. In 1990 they converted a large factory warehouse off the Old Kent Road and set it up to cook meals, provide beds, games, televisions, hairdressing, chiropody, medical and dental care--and information on housing, as well as general advice. Washing and cleaning facilities were provided in Portakabins parked in the yard outside the warehouse. Guests were provided with a complete change of clothing, which were altered to fit if necessary.

  17. Space maintenance in a child dental care program.

    Science.gov (United States)

    Hill, C J; Sorenson, H W; Mink, J R

    1975-04-01

    Five types of space maintainers were placed in 196 children participating in an extensive dental care program during a four-year study. Children with space maintainers were examined at six-month intervals. During the study, some sort of difficulty was encountered with 43% of the appliances inserted. The most common problem encountered was lost or missing appliances. Sixteen appliances had broken arch wires or loop wires; only ten broken bands were noted. Anther problem was distortion of arch wires. Suggestions are made for possible modifications in the space maintainers to reduce the incidence of problems.

  18. Interprofessional education: the inclusion of dental hygiene in health care within the United States – a call to action

    OpenAIRE

    Vanderbilt AA; Isringhausen KT; Bonwell PB

    2013-01-01

    Allison A Vanderbilt,1 Kim T Isringhausen,2 Patricia Brown Bonwell2,3 1Center on Health Disparities and School of Medicine, 2Department of Oral Health Promotion and Community Outreach, School of Dentistry, 3Dental Hygiene Program, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA Abstract: There is a lack of access to oral health care in the United States for rural, underserved, uninsured, and low-income populations. There are widely recognized problems with the US hea...

  19. Catalog of Completed Health Care and Dental Care Studies.

    Science.gov (United States)

    1987-12-01

    Webster University, MEN RSHIP: Nominee: American College of Health Care Executives Member: American Hospital Association Hospital Management System...the needs of the Army, Mil itiry Police Journal, 12-13. 31 Georgoulakis, James M. (1984). The AWOL offender: new findings on an old subject, 26th...Yuille, D., Telepak, R.J., Lamibrecht, R.W., & McAuley, R.J. (1978). Radionuclide nurshmal low swallow for evaluation of dysphagia . Journal of

  20. Integrating a primary oral health care approach in the dental curriculum: a Tanzanian experience.

    Science.gov (United States)

    Mumghamba, Elifuraha G

    2014-01-01

    This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated.

  1. Clinical profile of orofacial infections: An experience from two primary care dental practices

    OpenAIRE

    Kudiyirickal, Marina G.; Hollinshead, Frank

    2012-01-01

    Objectives: Orofacial infections are common reasons for dental consultations worldwide. However, there is scarcity of data on clinico-epidemiological profiles reported from primary care dental practices. To address this issue, a study was done to characterize the clinical pattern, age groups affected and sex predilection of orofacial infections in the primary care dental practice. Study design: Clinical data was evaluated from random electronic files of patients for whom antimicrobials were p...

  2. Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil

    Science.gov (United States)

    dos Reis, Clarice Magalhães Rodrigues; da Matta Machado, Antonio Thomaz Gonzaga; do Amaral, João Henrique Lara

    2016-01-01

    This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions. PMID:27755603

  3. Experiences of Dental Care and Dental Anxiety in Adults with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    My Blomqvist

    2014-01-01

    Full Text Available Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD.

  4. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    Science.gov (United States)

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p dental care (p dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts.

  5. Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

    2015-10-01

    Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge.

  6. Assessment, authorization and access to medicaid managed mental health care.

    Science.gov (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  7. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

    Directory of Open Access Journals (Sweden)

    Åstrøm Anne

    2009-11-01

    Full Text Available Abstract Background HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics, enabling (knowledge, attitudes and perceived risk related to HIV and need related factors (oral health status predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Methods Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH and University of Science and Technology (UST during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH were examined clinically (DMFT and participated in an interview. Results A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5 were associated with lower odds and females were associated with higher odds (OR = 2.0 for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6 and higher HIV related experience (OR = 0.7 were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3 were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8. Conclusion Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to

  8. [Adherence to oral hygiene and dental self-care].

    Science.gov (United States)

    Poplinger, A

    2010-04-01

    Nearly every person will be in need of dental treatment in his lifetime, whether purely for health causes or alternately for esthetic issues. Yet the main reasons of seeking dental treatment are in fact Caries, Gingivitis and Periodontitis. In spite of the fact that these pathologies occur due to the accumulation of Plaque around the oral cavity and teeth, they are fairly easy to prevent. Using simple techniques such as oral rinsing, flossing and brushing of the teeth, are normally sufficient for obtaining good oral health. If this is actually the case, than how is it that we are witnessing a massive spread of dental problems? How come there are so many incidents of people suffering from dental problems if the preventative care is that easy to manage? The answer lies in the concept of Adherence, referring to the cooperation of an individual with the demands of his treatment regime and the dental staff. The idea of promoting health adherence aims mainly for using medication, attending the periodic inspections and examination, and making lifestyle changes such as preventive care illustrated above. This article exemplifies how one of the current trends in Medical Psychology discipline is to enhance adherence by establishing a secure therapeutic alliance which is based upon a positive relationship between the patient and his doctor, increasing patient's confidence and sense of self-efficacy, and recruiting family members and friends to the patient's process of change. A distinctive emphasis is put on expanding the patient's knowledge about his condition, and raising awareness to the linkage between his medical (to be more specific-dental) problem and its symptoms to the implications. The most modish and putative intervention nowadays is Patient Centered, where the guiding principles used are urging the patient to be responsible for implying the treatment regime, taking active participation, and make decisions regarding his current and future status. This article

  9. Access to oral health care services among adults with learning disabilities: a scoping review

    Science.gov (United States)

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H.; Khalil, Hesham S.

    2016-01-01

    Summary Background The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. Objectives The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods Using the Arksey O’Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet. PMID:28149451

  10. Measuring service quality of public dental health care facilities in Kelantan, Malaysia.

    Science.gov (United States)

    John, Jacob; Yatim, Fekriah Mohd; Mani, Shani Ann

    2011-09-01

    This study investigates patients' expectations and perceptions of service quality in public dental health care and measures their "satisfaction gap." This descriptive study involved 481 dental outpatients in Kelantan, Malaysia. A modified SERVQUAL 20-item instrument was used to assess patients' expectations before and perceptions after receiving dental treatment. The "satisfaction gap" was then measured. showed that patients visiting for management of dental pain were more satisfied (P = .007) than those visiting with appointment. The most significant service quality dimensions were related to responsiveness, assurance, and empathy of the dental health care providers. There was a significant difference between the patients' expectations and their perceptions of service provided (P < .01) with regard to all dimensions. In conclusion, dental service providers should give emphasis to the compassionate and emotional aspects of care and to remember that they are integral components of quality service.

  11. Cross-sectional study of preventive dental knowledge among adult patients seeking dental care in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Salwa A. AlSadhan

    2017-01-01

    Full Text Available Aim: To evaluate the current knowledge about oral health and preventive dentistry among adults seeking dental care in Riyadh, Saudi Arabia. Materials and methods: A cross-sectional descriptive study was conducted in which 900 questionnaires were randomly distributed to adults seeking dental care in all health settings in Riyadh; 450 questionnaires were distributed in each of the governmental and the private sectors. The questionnaire included questions regarding socio-demographic factors (age, education, occupation, etc and others concerning the patient’s knowledge of preventive dental measures; the oral hygiene procedures, fluoride and sealant applications and the healthy dietary habits. Statistical analysis was performed using SPSS and simple descriptive statistics as means and frequency distributions were calculated for the study variables. Comparisons were performed using Chi-square test. Results: Eighty-six percent of the study subjects knew that dental caries could be prevented. Almost 59% were aware of the relation between frequency of sugar intake and dental caries. The prevalence of patients who knew that fluoride prevents dental caries was 50.3%, however, only 34.2% reported previous applications of topical fluoride in dental clinics. About 16% of the participants had received fissure sealants although 42.4% knew about them. The study sample’s dietary knowledge had statistically significant relations with education and occupation (p < 0.0001. Correct knowledge of visiting the dental clinic was statistically significantly related to education (p < 0.0001. Conclusion: It can be concluded that the majority of adults in Riyadh have the correct preventive dental knowledge, which is mostly related to the individuals’ educational level and occupation.

  12. Honoring Dental Patients' Privacy Rule Right of Access in the Context of Electronic Health Records.

    Science.gov (United States)

    Ramoni, Rachel B; Asher, Sheetal R; White, Joel M; Vaderhobli, Ram; Ogunbodede, Eyitope O; Walji, Muhammad F; Riedy, Christine; Kalenderian, Elsbeth

    2016-06-01

    A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.

  13. Access to special care dentistry, part 5. Safety.

    Science.gov (United States)

    Dougall, A; Fiske, J

    2008-08-23

    This article considers the delivery of efficient and effective dental services for patients whose disability and/or medical condition may not be obvious and which consequently can present a hidden challenge in the dental setting. Knowing that the patient has a particular condition, what its features are and how it impacts on dental treatment and oral health, and modifying treatment accordingly can minimise the risk of complications. The taking of a careful medical history that asks the right questions in a manner that encourages disclosure is key to highlighting hidden hazards and this article offers guidance for treating those patients who have epilepsy, latex sensitivity, acquired or inherited bleeding disorders and patients taking oral or intravenous bisphosphonates.

  14. Health-care access as a social determinant of health.

    Science.gov (United States)

    McGibbon, Elizabeth; Etowa, Josephine; McPherson, Charmaine

    2008-09-01

    The social determinants of health (SDH) are recognized as important indicators of health and well-being. Health-care services (primary, secondary, tertiary care) have not until recently been considered an SDH. Inequities in access to health care are changing this view. These inequities include barriers faced by certain population groups at point of care, such as the lack of cultural competence of health-care providers. The authors show how a social justice perspective can help nurses understand how to link inequities in access to poorer health outcomes, and they call on nurses to break the cycle of oppression that contributes to these inequities.

  15. Dental hygiene in Slovakia.

    Science.gov (United States)

    Luciak-Donsberger, C; Krizanová, M

    2004-08-01

    This article reports on the development of the dental hygiene profession in Slovakia from a global perspective. The aim is to inform about current developments and to examine, how access to qualified dental hygiene care might be improved and how professional challenges might be met. For an international study on dental hygiene, secondary source data were obtained from members of the House of Delegates of the International Federation of Dental Hygienists (IFDH) or by fax and e-mail from experts involved in the national professional and educational organization of dental hygiene in non-IFDH member countries, such as Slovakia. Responses were followed-up by interviews, e-mail correspondence, visits to international universities, and a review of supporting studies and reference literature. Results show that the introduction of dental hygiene in Slovakia in 1992 was inspired by the delivery of preventive care in Switzerland. Initiating local dentists and dental hygienists strive to attain a high educational level, equitable to that of countries in which dental hygiene has an established tradition of high quality care. Low access to qualified dental hygiene care may be a result of insufficient funding for preventive services, social and cultural lack of awareness of the benefits of preventive care, and of limitations inherent in the legal constraints preventing unsupervised dental hygiene practice. These may be a result of gender politics affecting a female-dominated profession and of a perception that dental hygiene is auxiliary to dental care. International comparison show that of all Eastern European countries, the dental hygiene profession appears most advanced in Slovakia. This is expressed in high evidence-based academic goals, in extensive work with international consultants from the Netherlands and Switzerland, in annual congresses of high professional quality, and in the establishment of a profession, which has not been introduced in all Western EU countries.

  16. Factors associated with dental health care coverage in Mexico: Findings from the National Performance Evaluation Survey 2002-2003.

    Science.gov (United States)

    Pérez-Núñez, Ricardo; Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; Vargas-Palacios, Armando

    2006-10-01

    To determine the level of dental health care coverage in people aged > or =18 years across the country, and to identify the factors associated with coverage. Using the instruments and sampling strategies developed by the World Health Organization for the World Health Survey, a cross-sectional national survey was carried out at the household and individual (adult) levels. Dental data were collected in 20 of Mexico's 32 states. The relationship between coverage and environmental and individual characteristics was examined through logistic regression models. Only 6098 of 24 159 individual respondents reported having oral problems during the preceding 12 months (accounting for 14 284 621 inhabitants of the country if weighted). Only 48% of respondents reporting problems were covered, although details of the appropriateness, timeliness and effectiveness of the intervention(s) were not assessed. The multivariate regression model showed that higher level of education, better socioeconomic status, having at least one chronic disease and having medical insurance were positively associated with better dental care coverage. Age and sex were also associated. Overall dental health care coverage could be improved, assuming that ideal coverage is 100%. Some equality of access issues are apparent because there are differences in coverage across populations in terms of wealth and social status. Identifying the factors associated with sparse coverage is a step in the right direction allowing policymakers to establish strategies aimed at increasing this coverage, focusing on more vulnerable groups and on individuals in greater need of preventive and rehabilitative interventions.

  17. A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

    Science.gov (United States)

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

  18. Effect of dental care programme and fluoridation in the prevention of dental caries in asthmatic children.

    Science.gov (United States)

    Kilinc, Gulser; Uzuner, Nevin; Karaman, Ozkan

    2016-11-01

    To investigate the effect of a regular dental care programme on the dental health of asthmatic children. This prospective, controlled study was conducted at Dokuz Eylul University, Izmir, Turkey, between 2012 and 2014, and comprised asthmatic and non-asthmatic children between 4 and 16 years of age who used inhaler corticosteroid treatment for at least 1 year. Patients were examined for dental caries, gingival index, salivary flow rate, and salivary pH values at baseline, 6 months, and at the end of the first year. Demographic features and tooth-brushing habits of the asthmatic and non-asthmatic children were also analysed. SPSS 20 was used for data analysis. Of the 102 patients, there were 51(50%) each in asthmatic and non-asthmatic groups. Besides, 38(70.6%) participants were boys and 15(29.4%) were girls in the first group compared to 30(58.8%) boys and 21(41.2%) girls in the second group. The mean age was 11.16±3.10 years and 10.33±2.62 years, respectively, in the two groups. The number of asthmatic patients was 45(88.2%) in visit 2 and 37(72.5%) in visit 3, whereas the number of participants for the control group was 41(80.4%) in visit 2 and 36(70.4%) in visit 3. During the first visit, mean values for salivary pH and flow rate were 7.135 0.15 and 3.878 0.71 mL/min among asthma patients, and 7.158 0.14 and 4.684 0.50 among controls. In the first visit, the rate of gingivitis was 31(60.8%) in asthmatic children and 12(23.5%) in the control group. During the third visit, the rate was 4(11.1%) and 5(13.5%) among the two groups, respectively. Decreased salivary flow rates associated with the drugs used by asthmatic patients caused an increase in the rate of dental caries and gingival disorders.

  19. The role of tobacco use on dental care and oral disease severity within community dental clinics in Japan.

    Science.gov (United States)

    Ojima, Miki; Hanioka, Takashi; Shimada, Kaoru; Haresaku, Satoru; Yamamoto, Mito; Tanaka, Keiko

    2013-01-01

    To examine facilitators of dental smoking intervention practices in Japan, where smokeless tobacco is rarely used, we evaluated the characteristics of dental care for smokers. Community dentists volunteered to record the treated disease or encounter with patients that was principally responsible for their dental care on the survey day. Patients were classified into groups receiving gingival/periodontal treatment (GPT), caries/endodontic treatment (CET), prosthetic treatment (PRT), periodical check-up/orthodontic treatment (POT), or other encounters/treatments. Potential effect of dentist clustering was adjusted by incorporating the complex survey design into the analysis. Data of 2835 current smokers (CS) and 6850 non-smokers (NS) from 753 clinics were analysed. Distribution of treatments significantly differed between CS and NS (P = 0.001). In ad hoc multiple comparisons for each treatment, CS were significantly higher than NS for CET (47.1% vs. 43.6%, P = 0.002), and lower for POT (1.6% vs. 2.7%, P = 0.001), whereas GPT and PRT proportions were equivalent by smoking. When stage of disease progression was compared in the GPT subpopulation, CS were more likely received treatment for advanced stage disease than NS in the age groups of 40-59 years (24.9% vs. 15.3%, P = 0.001) and more than 60 years (40.8% vs. 22.1%, P smoking with type of dental care of CET and GPT severity would warrant the need for dental professionals to engage their patients smoking within clinical practice. The detrimental effects of smoking in dental care for smokers, as evidenced by the distribution of treatment and encounter and stage of treated disease, may not be clearly realized by dental professionals, unless the smoking status of all patients is identified.

  20. The Oral Health Self-Care Behavior and Dental Attitudes among Nursing Home Personnel.

    Science.gov (United States)

    Wiener, R Constance; Meckstroth, Richard

    2014-03-01

    The need for nursing home care will increase for the next several decades. Rural areas will be impacted in particular, as many older adults live in rural areas. Daily oral infection control changes when a person moves from independent living to institutional living. Oral care to dependent individuals is influenced by many factors. The purpose of this study is to determine the association of oral health self-care behavior with dental attitudes in nursing home personnel in a rural state. A survey was provided to attendees at an oral health conference. Questions were asked to determine dental knowledge, oral health self-care behavior, and dental care attitudes. Of 128 long term care health care facilities' personnel invited, there were 31 attendees, and 21 of the attendees participated (67.7%). Nursing home personnel had a high level of dental knowledge. Oral health self-care behavior was independently influenced by dental knowledge (β=0.17; p=0.0444) and dental attitudes (β=0.55; p=.0081). Further investigation is needed to determine if oral health self-care attitudes and oral self-care behavior of nursing home personnel are factors in the provision of quality daily oral infection control for dependent nursing home residents living in rural areas.

  1. Oral health need and access to dental services: evidence from the National Survey of Children's Health, 2007.

    Science.gov (United States)

    Bell, Janice F; Huebner, Colleen E; Reed, Sarah C

    2012-04-01

    This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.

  2. Geography matters: state-level variation in children's oral health care access and oral health status.

    Science.gov (United States)

    Fisher-Owens, S A; Soobader, M J; Gansky, S A; Isong, I A; Weintraub, J A; Platt, L J; Newacheck, P W

    2016-05-01

    To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences. Observational study using cross-sectional surveys. Using the 2007 National Survey of Children's Health, we examined state variation in parents' report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighbourhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of the population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ∼¼ of the state variation in no preventive visit and ∼½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Competition, gatekeeping, and health care access.

    Science.gov (United States)

    Godager, Geir; Iversen, Tor; Ma, Ching-to Albert

    2015-01-01

    We study gatekeeping physicians' referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008-2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl-Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care.

  4. Medical care transition planning and dental care use for youth with special health care needs during the transition from adolescence to young adulthood: a preliminary explanatory model.

    Science.gov (United States)

    Chi, Donald L

    2014-05-01

    The aims of the study were to test the hypotheses that youth with special health care needs (YSHCN) with a medical care transition plan are more likely to use dental care during the transition from adolescence to young adulthood and that different factors are associated with dental utilization for YSHCN with and YSHCN without functional limitations. National Survey of CSHCN (2001) and Survey of Adult Transition and Health (2007) data were analyzed (N = 1,746). The main predictor variable was having a medical care transition plan, defined as having discussed with a doctor how health care needs might change with age and having developed a transition plan. The outcome variable was dental care use in 2001 (adolescence) and 2007 (young adulthood). Multiple variable Poisson regression models with robust standard errors were used to estimate covariate-adjusted relative risks (RR). About 63 % of YSHCN had a medical care transition plan and 73.5 % utilized dental care. YSHCN with a medical care transition plan had a 9 % greater RR of utilizing dental care than YSHCN without a medical care transition plan (RR 1.09; 95 % CI 1.03-1.16). In the models stratified by functional limitation status, having a medical care transition plan was significantly associated with dental care use, but only for YSHCN without functional limitations (RR 1.11; 95 % CI 1.04-1.18). Having a medical care transition plan is significantly associated with dental care use, but only for YSHCN with no functional limitation. Dental care should be an integral part of the comprehensive health care transition planning process for all YSHCN.

  5. Assessment of dentally related functional competency for older adults with cognitive impairment--a survey for special-care dental professionals.

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer J J

    2013-01-01

    This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population.

  6. Program for coordinated dental care under general anaesthesia for children with special needs.

    Science.gov (United States)

    de Nova-García, M Joaquín; Martínez, M Rosa Mourelle; Sanjuán, Carmen Martín; López, Nuria E Gallardo; Cabaleiro, Esther Carracedo; García, Yolanda Alonso

    2007-12-01

    To draw up a program for coordination of dental care for children with special needs between the Course at the Universidad Complutense de Madrid (UCMC) (Specialisation in holistic dental care for children with special needs), and the Disabled Children's Oral Health Unit (DCOHU) within the Madrid Health Service (SERMAS). UCMC Protocol for children with special needs. Design of a clinical pathway based on consensus amongst the professionals involved. Algorithm for dental care for children with special needs. Matrix covering all activities and timing for full dental diagnosis in such patients (general health, oral health and behaviour) to facilitate proper referral of patients requiring general anaesthesia. Inclusion in the matrix of those responsible for each activity. Improved team work (University - primary health care) in patient evaluation, in provision of information to parents and guardians and in health care quality. From the teaching point of view, students learn to adopt a systematic approach in the decision-making process.

  7. Impact of a dental care program on the quality of life of children with and without caries.

    Science.gov (United States)

    Paula, Janice Simpson de; Sarracini, Karin Luciana Migliato; Ambrosano, Gláucia Maria Bovi; Pereira, Antônio Carlos; Meneghim, Marcelo de Castro; Mialhe, Fábio Luiz

    2016-12-22

    The aim of the present study was to evaluate the long-term effects of the caries treatment provided by a dental care program on changes in schoolchildren's OHRQoL. A one-year follow-up was conducted with a sample of 372 children aged 8 to 10 years which were clinically examined and divided into two matched groups according to their caries experience: dental treatment group (DTG) and group without caries (GWC). Both groups were assessed three times (at baseline, at 4 weeks, and at 1 year) using the Child Perceptions Questionnaire (CPQ8-10). The normality test was performed for the statistical analyses; the Friedman test was used for the dependent variables (longitudinal assessment repeated three times for the same group); and the Mann-Whitney test was used for the independent variables (test and control groups in each time period). There was improvement in all domains and in overall CPQ8-10 (p 0.05) were observed at baseline for overall CPQ8-10 and for the emotional well-being domain in the GWC. The comparison between groups demonstrated that OHRQoL was persistently better for the GWC (p dental caries treatment has a long-term positive impact on schoolchildren's OHRQoL, highlighting the importance of health policies that promote access to dental care for this population.

  8. Everyone Needs Regular Dental Care, but What if You Can't Get to the Dentist?

    Science.gov (United States)

    Blumin, Scott

    2011-01-01

    This article features the three-dentist House Call Dentist (HCD) team, a division of the nationally known Blende Dental Group based in San Francisco, headed by Dr. David Blende. Dr. Blende is best known for providing dental care utilizing sleep and sedation modalities, and as a leader in the field of dentistry for patients with special needs. The…

  9. Dental care of frail older people and those caring for them.

    Science.gov (United States)

    Nitschke, Ina; Majdani, Mahsa; Sobotta, Bernhard A J; Reiber, Thomas; Hopfenmüller, Werner

    2010-07-01

    To describe oral health utilisation patterns of frail older people and contrast these with attitudes and utilisation patterns of nursing staff who are caring for them. In view of widespread poor oral health of frail older people in long-term care, staff attitudes have been identified as an area of interest. In addition to data on attitudes, the current study contributes a description of aspects of oral health related behaviour of staff and clients. Cross-sectional study. Structured interviews of a random selection of long-term care staff (n=320) and frail older people (n=172), within the two groups of home-care services (HCS) and long-term care facilities (LTCF). Of staff members, 55·3% attach the same importance to their own oral health compared to that of clients and 35·7% regard their own oral health as more important; 98·4% of staff attended two or more dental examinations per year; 3·4% of HCS and 37·1% of LTCF routinely arranged oral examinations. In 81·4% HCS and in 34·4% of LTCF, there was no routine dental service available. Patterns of oral health service attendance greatly differ between staff and clients. The oral health awareness of the majority of long-term care staff did not translate into adequate oral health care for clients. A gap exists between attitudes supportive of oral health, adequate and prevention driven own oral health related behaviour of staff and actual oral health care delivered to clients. To bridge the gap identified, a concept is suggested for nursing educators and managers of LTCF targeting educational measures while taking into account individual attitudes. © 2010 Blackwell Publishing Ltd.

  10. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    Science.gov (United States)

    Radford, David R.; Gallagher, Jennifer E.

    2017-01-01

    Objective This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Methods Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008–2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients’ individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Results Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (tooth extraction’ (3%; p = 0.001), and ‘instruction and advice’ (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive ‘instruction and advice’ than non-smokers (OR 4.124; 95% CI: 3.088–5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely to receive ‘tooth extraction’ when compared with least deprived, and less likely to receive preventive ‘instruction and advice’ (p = 0.01). Conclusion This is the first study to model patient management data from a

  11. Patient satisfaction- comparison of the comprehensive care model with traditional model of delivering dental services in Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Afsaneh Pakdaman

    2013-10-01

    Full Text Available   Background and Aims: One of the important aspects for evaluating an organization is assessing the level of satisfaction of the clients. This study was conducted to compare the level of satisfaction between traditional and new methods of delivering dental care in the clinic of Tehran University of Medical Sciences.   Materials and Methods: A cross-sectional study was conducted on 308 patients received dental care at the dental clinics of Tehran University of Medical Sciences in spring 2010. Data were collected from Comprehensive Care Unit (CCU in addition to 7 isolated clinics including restorative, periodontics, endodontics, radiology, and prosthodontics (fix and removable using translated version of the Dental Satisfaction Questionnaire (DSQ, consisted of 19 questions in three main domains in addition to demographic questions. Descriptive statistics was used as percentage of answers. In order to compare the mean score between domains ANOVA test was used.   Results: The standardized mean scores in each domain were: pain control 58±17, access 59±12, quality 68±11 and total Dental Satisfaction Index (DSI score of 62±10. 92.5% of the respondents reported that students were very careful when examining their patients. 96.8% reported that they treat their patients with respect . The most common reasons for dissatisfaction apart from waiting time and getting appointments were not providing preventive care and pain control.   Conclusion: The results of this study shows acceptable level of satisfaction with dental care in teaching clinics of this dental school, however efforts on implementing preventive care and pain control strategies are suggested.

  12. The use of general anesthesia in pediatric dental care of children at multi-dental centers in Saudi Arabia.

    Science.gov (United States)

    Ba'akdah, Rania; Farsi, Najat; Boker, Abdulaziz; Al Mushayt, Abdullah

    2008-01-01

    High caries reports in young Saudi children strongly suggest the need occasionally for general anesthesia to provide quality dental work. The purpose of this study was to investigate the characteristics of patients, dental procedures and hospital protocols for Pediatric Dental General Anesthesia (PDGA) procedure at multi-dental centers in Jeddah, Saudi Arabia. Study sample included 90 children attending PDGA treatment at three governmental hospitals in Jeddah. Collected data included patient's demographics, medical condition, admission type, intra-operative protocols, and dental procedures. Results showed the mean age of treated children was 5 +/- 2 years and the majority of them (93%) were treated for the first time under general anesthesia (GA). Long waiting duration for PDGA procedure was reported regardless of the patient age and medical status. Being very young with extensive caries was the major indication for GA (58%). Children mean preoperative fasting times were 10 +/- 2 hours. Hospitals were significantly different in some protocols for PDGA procedures. Child behavior during GA induction was significantly related to child's age, premedication use, and hospital admission type. The mean number of treated teeth per child was 14 +/- 3.8 and the treatment mostly included restorations. Age was found to significantly affect the type of dental treatment, while gender and medical status did not. PDGA procedure is used mostly for young children with extensive dental caries. Children treated under GA received a comprehensive dental care in Saudi hospitals. Efforts should be directed to improve some of the existing hospitals protocols with PDGA procedure. The long waiting period for PDGA operation indicated the need to improve available facilities in the three hospitals.

  13. ORIGINAL ARTICLES Access to health care in South Africa - the ...

    African Journals Online (AJOL)

    Access to health care in South Africa - the influence of race and class. R Lalloo, M J .... number of consumer durables in the household; (iv) the highest educational .... Pillay YG, Bond P. Health and social policies in the new South Africa. Int J Health ... gender- do they affect reported health-care seeking behaviour. Soc Sci ...

  14. Dental Care Utilization and Satisfaction of Residential University Students

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    Bamise CT

    2008-01-01

    Full Text Available Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Information was collected by a self-administered questionnaire composed of questions that measure the level of utilization and satisfaction with the dental services provided. Questionnaires were provided to 650 randomly chosen students residing in the University hostels. There were 39 refusals, and 6 incomplete questionnaires were discarded. This left a sample size of 605 volunteers. Results: Forty seven students (7.8% indicated that they visited the dental hospital within the last 12 months. Males and females utilized the dental services equally, and utilization increased with age and the number of years spent on campus. Anticipation of painful dental treatment, high dental charges, long waiting times and being too busy for a dental visit were cited as the most important impediments to seeking dental treatment. Females expressed greater satisfaction with the services. Conclusion: Dental service utilization among the students was found to be low. Oral health awareness campaigns, improving the quality of the services, and shortening the waiting time are expected to increase service utilization and satisfaction.

  15. VA Health Care: Actions Needed to Improve Newly Enrolled Veterans Access to Primary Care

    Science.gov (United States)

    2015-03-01

    primary care provider and support staff—a nurse care manager, clinical associate, and administrative clerk. Letter Page 2 GAO-16-328...Health Eligibility Center, VHA central office—VHA’s Health Resource Center, Office of Primary Care, and Access and Clinical Administration Program ...newly enrolled veterans were able to access primary care from the Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA), and others

  16. Accessibility of professional health care (PRHC in greater Bloemfontein

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    S. J. E. J. van Vuuren

    1996-05-01

    Full Text Available The health of citizens is usually a priority in any society. In order to prevent/cure disease, people make use of various forms of care, ranging from lay care to professional health care (PRHC. Professional health care, however, is not equally accessible to all members of a society. This article attempts to indicate how factors such as costs, distance, consultation hours, attitude of medical personnel can result in PRHC being less accessible for some members and totally inaccessible for other members of a society. It is imperative that health care planners should once again review this issue in order to ensure that all South Africans are able to exercise their basic right to health care.

  17. Vascular Access Creation and Care--Perspective From India.

    Science.gov (United States)

    Sampathkumar, Krishnaswamy; Lobo, Valentine; Balasubramaniam, Jeyaraj; Mahaldar, Amol; Yevzlin, Alexander S; Kumbar, Lalathaksha

    2015-11-01

    India has one of the fastest growing economies in the world and is home to nearly one sixth of world's population. Chronic diseases such as diabetes mellitus and hypertension are common. Kidney disease is a known complication of these chronic diseases and is on the rise. Improving affordability with advanced care delivery has led to the increasing use of maintenance hemodialysis. Along with this hemodialysis comes the inevitable need for vascular access. Interventional nephrology in India is a fast-evolving discipline and promises to be a critical component of hemodialysis care in the future. This review provides a background on the current state of the CKD burden in India and the various vascular access options in use currently. In addition, we describe the experience of 2 centers in western and southern India in managing vascular access needs in hopes that they will serve as a model of the proliferation of vascular access care throughout India and in other developing countries.

  18. ANALISIS KEPUASAN PASIEN TERHADAP KUALITAS PELAYANAN PERAWATAN GIGI DI KLINIK GIGI MY DENTAL CARE SURABAYA

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    Adityarani Putranti

    2016-10-01

    Full Text Available Kebutuhan masyarakat yang semakin tinggi akan jasa layanan kesehatan membuat ekspektasi masyarakat terhadap layanan kesehatan yang baik juga semakin tinggi. Pelayanan gigi dan mulut, merupakan salah satu pelayanan kesehatan dasar pada masyarakat. Klinik gigi My Dental Care Surabaya merupakan salah satu klinik gigi yang terletak di Surabaya Selatan. Klinik Gigi My Dental Care memiliki permasalahan belum tercapainya target jumlah kunjungan pasien sebesar 120 pasien per bulan selama tahun 2013-2014. Jenis penelitian ini adalah penelitian analitik observasional dengan pengumpulan data secara cross sectional. Pengambilan sampel dengan metode simple random sampling dan jumlah sampel sebesar 30 orang. Penelitian ini dilakukan pada pasien yang melakukan perawatan gigi di Klinik Gigi My Dental Care Surabaya. Kata Kunci: Kepuasan Pelanggan, Kualitas Pelayanan, Klinik Gigi My Dental Care Surabaya

  19. Increasing prevalence of emergency department visits for pediatric dental care, 1997-2001.

    Science.gov (United States)

    Ladrillo, Teresita E; Hobdell, Martin H; Caviness, A Chantal

    2006-03-01

    Hospital emergency department (ED) visits for non-urgent care have been increasing since the late 1950s. This study investigated the prevalence and characteristics of pediatric ED visits for dental problems during a five-year period. This retrospective study included newborns through 17-year-olds with dental complaints identified from the electronic register of the ED of Texas Children's Hospital, Houston, between January 1997 and December 2001. The authors described patient characteristics, diagnoses, factors associated with ED use for nontraumatic problems and annual changes in ED visits for dental and nondental complaints. Of the 1,102 subjects, 809 (73.4 percent) had nontraumatic and 293 (26.6 percent) had traumatic dental complaints. The study revealed a 121 percent increase in ED visits for dental complaints and a 66-fold increase in admissions between 1997 and 2001. Of the inpatient admissions, 68 percent were the result of caries and its sequelae. This study revealed a substantial increase in ED visits and hospital admissions for dental problems during the study period. The majority of dental problems were nontraumatic in nature. Dental care experts should be available in ED settings in which increases in such visits are seen. Studies must be conducted to explore ways of keeping patients from seeking care in EDs inappropriately.

  20. Income inequality, disinvestment in health care and use of dental services.

    Science.gov (United States)

    Bhandari, Bishal; Newton, Jonathan T; Bernabé, Eduardo

    2015-01-01

    To explore the interrelationships between income inequality, disinvestment in health care, and use of dental services at country level. This study pooled national estimates for use of dental services among adults aged 18 years or older from the 70 countries that participated in the World Health Survey from 2002 to 2004, together with aggregate data on national income (GDP per capita), income inequality (Gini coefficient), and disinvestment in health care (total health expenditure and dentist-to-population ratio) from various international sources. Use of dental services was defined as having had dental problems in the last 12 months and having received any treatment to address those needs. Associations between variables were explored using Pearson correlation coefficients and linear regression. Data from 63 countries representing the six WHO regions were analyzed. Use of dental services was negatively correlated with Gini coefficient (Pearson correlation coefficient -0.48, P dental services was attenuated but remained significant after adjustments for GDP per capita, total health expenditure, and dentist-to-population ratio (regression coefficient -0.36; 95% CI -0.57, -0.15). This study shows an inverse relationship between income inequality and use of dental services. Of the two indicators of disinvestment in health care assessed, only dentist-to-population ratio was associated with income inequality and use of dental services. © 2014 American Association of Public Health Dentistry.

  1. Oral health considerations in anorexia and bulimia nervosa. 2. Multidisciplinary management and personalized dental care.

    Science.gov (United States)

    Bassiouny, Mohamed A; Tweddale, Elizabeth

    2017-01-01

    This article outlines a comprehensive, multidisciplinary strategy for treatment of patients with anorexia and bulimia nervosa. In this approach, primary medical intervention and emergency dental care are followed by the staging of treatment phases that integrate medical care, psychotherapy, nutritional counseling, and dental management, which may encompass various treatment options for repair of damaged dentition. Emphasis is placed on prevention of further tissue damage during all phases of management and following completion of the treatment course.

  2. Access to care: the physician's perspective.

    Science.gov (United States)

    Tice, Alan; Ruckle, Janessa E; Sultan, Omar S; Kemble, Stephen

    2011-02-01

    Private practice physicians in Hawaii were surveyed to better understand their impressions of different insurance plans and their willingness to care for patients with those plans. Physician experiences and perspectives were investigated in regard to reimbursement, formulary limitations, pre-authorizations, specialty referrals, responsiveness to problems, and patient knowledge of their plans. The willingness of physicians to accept new patients from specific insurance company programs clearly correlated with the difficulties and limitations physicians perceive in working with the companies (p<0.0012). Survey results indicate that providers in private practice were much more likely to accept University Health Alliance (UHA) and Hawaii Medical Services Association (HMSA) Commercial insurance than Aloha Care Advantage and Aloha Quest. This was likely related to the more favorable impressions of the services, payments, and lower administrative burden offered by those companies compared with others.

  3. Desigualdades no acesso e na utilização de serviços odontológicos no Brasil: análise do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL 2009 Inequalities in access to and utilization of dental care in Brazil: an analysis of the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL 2009

    Directory of Open Access Journals (Sweden)

    Marco A. Peres

    2012-01-01

    access to dental care was more frequent among women, young adults, less educated individuals, and among lightener-skinned blacks. Our findings highlight sharp inequalities in the use of and access to dental services in the Brazilian State capitals.

  4. Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

    Science.gov (United States)

    RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

    2012-01-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. PMID:21162350

  5. WEALTH EFFECT AND DENTAL CARE UTILIZATION IN THE U.S.

    Science.gov (United States)

    Manski, Richard J.; Moeller, John F.; Chen, Haiyan; Clair, Patricia A. St.; Schimmel, Jody; Pepper, John V.

    2012-01-01

    Objective The purpose of this article is to examine the relationship of wealth and income and the relative impact of each on dental utilization in a population of older Americans, using data from the Health and Retirement Study (HRS). Methods Data from the Health and Retirement Study (HRS) were analyzed for U.S. individuals aged 51 years and older during the 2008 wave of the HRS. The primary focus of the analysis is the relationship between wealth, income and dental utilization. We estimate a multivariable model of dental use controlling for wealth, income and other potentially confounding covariates. Results We find that both wealth and income each have a strong and independent positive effect on dental care use of older Americans [pdental care utilization as wealth increases depends on a person's income level, or, alternatively, that the impact on dental use as income increases depends on a person's household wealth status [p>.05]. Conclusions Relative to those living in the wealthiest U.S. households, the likelihood of utilizing dental care appears to decrease with a decline in wealth. The likelihood of utilizing dental care also appears to decrease with a decline in income as well. PMID:22515635

  6. Personalized medicine and access to health care: potential for inequitable access?

    Science.gov (United States)

    McClellan, Kelly A; Avard, Denise; Simard, Jacques; Knoppers, Bartha M

    2013-02-01

    Personalized medicine promises that an individual's genetic information will be increasingly used to prioritize access to health care. Use of genetic information to inform medical decision making, however, raises questions as to whether such use could be inequitable. Using breast cancer genetic risk prediction models as an example, on the surface clinical use of genetic information is consistent with the tools provided by evidence-based medicine, representing a means to equitably distribute limited health-care resources. However, at present, given limitations inherent to the tools themselves, and the mechanisms surrounding their implementation, it becomes clear that reliance on an individual's genetic information as part of medical decision making could serve as a vehicle through which disparities are perpetuated under public and private health-care delivery models. The potential for inequities arising from using genetic information to determine access to health care has been rarely discussed. Yet, it raises legal and ethical questions distinct from those raised surrounding genetic discrimination in employment or access to private insurance. Given the increasing role personalized medicine is forecast to play in the provision of health care, addressing a broader view of what constitutes genetic discrimination, one that occurs along a continuum and includes inequitable access, will be needed during the implementation of new applications based on individual genetic profiles. Only by anticipating and addressing the potential for inequitable access to health care occurring from using genetic information will we move closer to realizing the goal of personalized medicine: to improve the health of individuals.

  7. Improving outpatient access and patient experiences in academic ambulatory care.

    Science.gov (United States)

    O'Neill, Sarah; Calderon, Sherry; Casella, Joanne; Wood, Elizabeth; Carvelli-Sheehan, Jayne; Zeidel, Mark L

    2012-02-01

    Effective scheduling of and ready access to doctor appointments affect ambulatory patient care quality, but these are often sacrificed by patients seeking care from physicians at academic medical centers. At one center, Beth Israel Deaconess Medical Center, the authors developed interventions to improve the scheduling of appointments and to reduce the access time between telephone call and first offered appointment. Improvements to scheduling included no redirection to voicemail, prompt telephone pickup, courteous service, complete registration, and effective scheduling. Reduced access time meant being offered an appointment with a physician in the appropriate specialty within three working days of the telephone call. Scheduling and access were assessed using monthly "mystery shopper" calls. Mystery shoppers collected data using standardized forms, rated the quality of service, and transcribed their interactions with schedulers. Monthly results were tabulated and discussed with clinical leaders; leaders and frontline staff then developed solutions to detected problems. Eighteen months after the beginning of the intervention (in June 2007), which is ongoing, schedulers had gone from using 60% of their registration skills to over 90%, customer service scores had risen from 2.6 to 4.9 (on a 5-point scale), and average access time had fallen from 12 days to 6 days. The program costs $50,000 per year and has been associated with a 35% increase in ambulatory volume across three years. The authors conclude that academic medical centers can markedly improve the scheduling process and access to care and that these improvements may result in increased ambulatory care volume.

  8. Pattern of Utilisation of Dental Health Care Among HIV-positive Adult Nigerians.

    Science.gov (United States)

    Adedigba, Michael A; Adekanmbi, Victor T; Asa, Sola; Fakande, Ibiyemi

    2016-01-01

    To determine the pattern of dental care utilisation of people living with HIV (PLHIV). A cross-sectional questionnaire survey of 239 PLHIV patients in three care centres was done. Information on sociodemographics, dental visit, risk groups, living arrangement, medical insurance and need of dental care was recorded. The EC Clearinghouse and WHO clinical staging was used to determine the stage of HIV/AIDS infection following routine oral examinations under natural daylight. Multivariate logistic regression models were created after adjusting for all the covariates that were statistically significant at univariate/bivariate levels. The majority of subjects were younger than 50 years, about 93% had not seen a dentist before being diagnosed HIV positive and 92% reported no dental visit after contracting HIV. Among nonusers of dental care, 14.3% reported that they wanted care but were afraid to seek it. Other reasons included poor awareness, lack of money and stigmatisation. Multivariate analysis showed that lack of dental care was associated with employment status, living arrangements, educational status, income per annum and presenting with oral symptoms. The area under the receiver operating curve was 84% for multivariate logistic regression model 1, 70% for model 2, 67% for model 3 and 71% for model 4, which means that the predictive power of the models were good. Contrary to our expectations, dental utilisation among PLHIV was generally poor among this group of patients. There is serious and immediate need to improve the awareness of PLHIVs in African settings and barriers to dental care utilisation should also be removed or reduced.

  9. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

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    Chaudhari Monica

    2012-07-01

    Full Text Available Abstract Background About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. Methods Data included secondary enrollment and demographic data from Washington Dental Service (WDS and Group Health Cooperative (GH, clinical data from GH, and dental-utilization data from WDS claims during 2002–2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. Results We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p  0.001. Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR = 0.77, fillings (OR = 0.80 and crowns (OR = 0.84 (p 0.005 for all and higher odds of receiving periodontal maintenance (OR = 1.24, non-surgical periodontal procedures (OR = 1.30, extractions (OR = 1.38 and removable prosthetics (OR = 1.36 (p  Conclusions Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.

  10. Care coordination impacts on access to care for children with special health care needs enrolled in Medicaid and CHIP.

    Science.gov (United States)

    Miller, Kipyn

    2014-05-01

    Children with special health care needs (CSHCN) often require services from multiple health care providers. This study's objective is to evaluate whether CSHCN, enrolled in Medicaid or the Children's Health Insurance Program (CHIP) and receiving care coordination services, experience improved access to mental and specialty health care services. Using data from the 2009-2010 National Survey of Children with Special Health Care Needs, two separate outcomes are used to evaluate children's access to care: receipt of needed mental and specialty care and timely access to services. Using propensity score matching, CSHCN propensity for receiving care coordination services is derived and an assessment is made of care coordination's impact on the receipt of health care and whether care is delayed. Results demonstrate that care coordination is positively associated with whether a child receives the mental and specialty care that they need, regardless of whether or not that coordination is perceived to be adequate by parents. However, receiving care coordination services that parents perceive to be adequate has a larger impact on the timeliness in which care is received. This study indicates that care coordination is associated with an increased ability for CSHCN to access needed mental and specialty care. States should consider offering care coordination services that support provider communication and fulfill families' coordination needs to the CSHCN enrolled in their Medicaid and CHIP programs.

  11. Dental Health Care Models of Southwest Cultures. Final Report.

    Science.gov (United States)

    Pettibone, Timothy J.; Solis, Enrique, Jr.

    The major goal of this research was the development and validation of cultural models of dental health practices. The specific objectives were to determine if 3 cultural groups (American Indians, Mexican Americans, and Anglo Americans) differ in the dental health hygiene indices, characteristics, psychological factors, or social factors; to…

  12. PROVIDING DENTAL CARE FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

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    Diana MURARU

    2017-06-01

    Full Text Available Given the increasing prevalence of autism spectrum disorders, it is realistic to assume that dental professionals are likely to treat individuals with this diagnosis. Understanding the complexities of this disorder and its behavioral manifestations is indispensable for dentists. The present article presents several characteristics of autism spectrum disorder that impact dental interventions, along with medical and behavioral alternatives to better manage the dental problems of children with autism spectrum disorder. A multidisciplinary approach and family support are important for planning a dental intervention for these patients in order to avoid anxiety. Knowledge on autism, the dentist-patient relationship and the individual preparation for dental interventions is useful for constructing a controllable medical experience

  13. The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

    Science.gov (United States)

    Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

    2017-12-01

    We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

  14. Human rights and immigrants’ access to care

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    Wendy Parmet

    2013-11-01

    Full Text Available Although the human right to health is well established under international law, many states limit non-citizens’ participation in public insurance programs. In the United States, immigrants face especially high barriers due to the lack of recognition of a broad right to health as well as federal statutes restricting many immigrants’ eligibility to federally-funded insurance. High rates of uninsurance among immigrants have a detrimental effect on their health, as well as on the health of citizens who live in their communities. Finch vs. Commonwealth Health Insurance Connector, a recent case decided by the Supreme Judicial Court of Massachusetts, recognized the rights of legal immigrants in Massachusetts to state-supported health care, and demonstrates the importance of insuring immigrants in broadly-based, rather than immigrant-specific, programs.

  15. Affordability of population towards dental care in Mathura City—A household survey

    Directory of Open Access Journals (Sweden)

    Maj Kundan Kumar

    2013-01-01

    Full Text Available Objectives The purpose of this study was to assess the factors of affordability towards dental care in Mathura city. Material and Methods The present study included 100 households from which 100 persons were interviewed above the age group of 25 years. Data was collected with the help of structured Questionnaires & Face interviews. Information was collected regarding Socio-demographic variables & attitudes of the subjects towards the utilization of dental service and the affordability of the dental services. The data was then statistically analyzed using chi square test. Results In the present study it was found that the income and education were significantly associated with the affordability of the dental services. Individuals having an income of above Rs 20, 000/ were found to afford the available dental care. Individuals having educational qualification of graduate and above were utilizing the dental services better than others. Conclusion Within the limitation of this study, we can conclude that the utilization of dental services is not very high among Mathura city population. The affordability factor such as income, education and occupation were identified as the major factor towards utilization of dental services. However place of visit differs according to income, education and occupation.

  16. Mercury in dental amalgam: Are our health care workers at risk?

    Science.gov (United States)

    Sahani, M; Sulaiman, N S; Tan, B S; Yahya, N A; Anual, Z F; Mahiyuddin, W R Wan; Khan, M F; Muttalib, K A

    2016-11-01

    Dental amalgam in fillings exposes workers to mercury. The exposure to mercury was investigated among 1871 dental health care workers. The aim of the study was to evaluate the risk of mercury exposure among dental compared to nondental health care workers and to determine other risk factors for mercury exposure. Respondents answered questionnaires to obtain demographic, personal, professional, and workplace information and were examined for their own amalgam fillings. Chronic mercury exposure was assessed through urinary mercury levels. In total, 1409 dental and 462 nondental health care workers participated in the study. Median urine mercury levels for dental and nondental health care workers were 2.75 μg/L (interquartile range [IQR] = 3.0175) and 2.66 μg/L (IQR = 3.04) respectively. For mercury exposure, there were no significant risk factor found among the workers involved within the dental care. The Mann-Whitney test showed that urine mercury levels were significantly different between respondents who eat seafood more than 5 times per week compared to those who eat it less frequently or not at all (p = 0.003). The urinary mercury levels indicated significant difference between dental workers in their practice using squeeze cloths (Mann-Whitney test, p = 0.03). Multiple logistic regression showed that only the usage of cosmetic products that might contain mercury was found to be significantly associated with the urinary mercury levels (odds ratio [OR] = 15.237; CI: 3.612-64.276). Therefore, mean urinary mercury levels of health care workers were low. Exposure to dental amalgam is not associated with high mercury exposure. However, usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.

  17. Identifying predictors of satisfaction with access to medical care and quality of care.

    Science.gov (United States)

    Jatulis, D E; Bundek, N I; Legorreta, A P

    1997-01-01

    Satisfaction with access to medical care and quality of care were compared using a survey instrument adapted from the Group Health Association of America Consumer Satisfaction Survey. Participants were members of a large health maintenance organization employed by an employer group (Company) and other non-company members (Control). Overall, members reported high satisfaction with both access to medical care and quality of care. There were no significant differences in satisfaction between Company and Control respondents. Stepwise regression identified the strongest predictor of satisfaction with access to care as ease of arranging appointments. Satisfaction with quality of care was predicted most strongly by outcomes of medical care. These findings indicate that items with which members are least satisfied (access to doctor after hours, office waiting time, and time for routine appointment) do not predict either satisfaction with access to care or satisfaction with quality of care. Managed care organizations must develop and utilize evidence-based evaluation tools such as this one to assess the quality of care.

  18. A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Pine, Cynthia; Adair, Pauline; Burnside, Girvan; Robinson, Louise; Edwards, Rhiannon Tudor; Albadri, Sondos; Curnow, Morag; Ghahreman, Marjan; Henderson, Mary; Malies, Clare; Wong, Ferranti; Muirhead, Vanessa; Weston-Price, Sally; Whitehead, Hilary

    2015-11-04

    In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have

  19. The emergency department as a 'last resort': why parents seek care for their child's nontraumatic dental problems in the emergency room.

    Science.gov (United States)

    Mostajer Haqiqi, Azadeh; Bedos, Christophe; Macdonald, Mary Ellen

    2016-10-01

    Over the last two decades, there has been an increasing trend in the number of families using emergency departments (EDs) for treating their children's nontraumatic dental problems. We do not know why families use the ED in this way; to date, little research has addressed parents' decisions. The purpose of this study was to explore the reasons that lead parents to select the ED over a dental clinic for their child's nontraumatic dental problem. Using a qualitative descriptive design, we conducted semi-structured interviews with parents of children under age 10 who sought care for nontraumatic dental problems in an ED of a pediatric hospital. The interviews were audio-recorded, transcribed, and coded for thematic analysis using Grembowski's dental care process model as a sensitizing construct. Fifteen parents were recruited (ten mothers and five fathers). Three salient themes were identified: (i) parental beliefs and socioeconomic challenges which contributed to their care seeking, (ii) barriers parents faced in finding oral healthcare options for their children in their communities (e.g., poor access to care and poor quality of care), and (iii) parent's high satisfaction with the care provided through the ED. The ED was families' last resort; parents took their child to the ED because of the lack of other options in their communities rather than a belief that the ED was the best choice for dental care. The current pattern of ED use resulted in stress for these parents and repercussions for the children (e.g., pain, longer waiting, and increased complications); further, it has been shown in the literature to be an economic strain on the health system. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Provision of dental care in aged care facilities, NSW, Australia - part 1 as perceived by the directors of nursing (care providers).

    Science.gov (United States)

    Webb, Bettine C; Whittle, Terry; Schwarz, Eli

    2013-09-01

    To ascertain the Directors of Nursing (DONs) perception of the provision of dental care and the difficulties in oral health maintenance for residents in New South Wales (NSW) aged care facilities (ACFs). There were no specific figures relating to DONs' perceptions of oral health needs and dental care nor obstructions to dental care of residents. A total of 414 questionnaires, encoded for confidentiality, were posted to all DONs of ACFs in NSW and the data analysed. Questionnaires were returned from 255 ACFs (response rate 61.6%) representing 16 861 residents with a male-to-female ratio of 1:3.45. Of these residents, 48% had a dental assessment on admission by qualified dental staff. In 74.2% of facilities, no regular visits by dental staff took place, and 58.6% considered the perceived unwillingness of dental professionals to visit residents a barrier to good oral health. DONs reported that 53.6% of residents had dentures only, while 18.3% had natural teeth only. The most frequent difficulties reported by staff were residents' use of abusive language (78.2%) and residents refusing to open mouth (60.9%). Lack of involvement of dental professionals in admission assessment and in ongoing programmes was of concern to DONs in ACFs. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  1. Licensure Portability: Assuring Access to Quality Care in Physical Therapy

    Directory of Open Access Journals (Sweden)

    Mark Lane

    2014-09-01

    Full Text Available The concurrent circumstances of an increasingly mobile workforce, disparities in access to healthcare, and the ability to deliver care through technology (e.g., telehealth present the need and the opportunity to practice across state borders. Over the past four years, the Federation of State Boards of Physical Therapy (FSBPT has explored professional licensure models that will allow cross border practice. This paper reviews FSBPT's exploratory process and describes some of the advantages of an interstate compact. It concludes that if agreement among state licensing boards can be achieved, a compact could serve as a viable means to increase patient access to quality physical therapy care

  2. Users’ dissatisfaction with dental care: a population-based household study

    Science.gov (United States)

    Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição; dos Santos, Pedro Eleutério; Carreiro, Danilo Lima; Souza, João Gabriel Silva; Ferreira e Ferreira, Efigênia

    2015-01-01

    OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users’ dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users’ dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units. PMID:26270017

  3. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care

    DEFF Research Database (Denmark)

    Andersen, L. B.; Bech, M.; Lauridsen, J.

    2012-01-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying...... spatial patterns in expenditure levels across municipalities, we are able to test the influences of these two main actors and the networks through which learning is achieved. Four hypotheses on the existence of different spatial spillover effects are tested. The empirical analysis is based on annual data...... from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore...

  4. Gaps in need, demand, and effective demand for dental care utilization among residents of Krishna district, Andhra Pradesh, India

    Science.gov (United States)

    Pradeep, Y.; Chakravarty, Kalyan K.; Simhadri, Kavya; Ghenam, Alexis; Naidu, Guntipalli M.; Vundavalli, Sudhakar

    2016-01-01

    Aims: To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India. Materials and Methods: This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables. Results: Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%). Conclusions: There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system. PMID:27652242

  5. Patients' Perceptions of Dental Students' Empathic, Person-Centered Care in a Dental School Clinic in Malaysia.

    Science.gov (United States)

    Babar, Muneer Gohar; Hasan, Syed Shahzad; Yong, Wong Mei; Mitha, Shahid; Al-Waeli, Haider Abdulameer

    2017-04-01

    Empathy has been identified as a crucial foundation in building an effective dentist-patient relationship. The aim of this study was to assess patients' perceptions of dental students' empathic care in the primary oral health care clinic at International Medical University in Kuala Lumpur, Malaysia in May-October 2014. The study also assessed the validity and reliability of the Consultation and Relational Empathy (CARE) Measure in this setting; the association between number of encounters and students' CARE Measure scores; and the association between students' empathy (measured by the Toronto Empathy Questionnaire) and CARE Measure scores. Participants were 283 patients (aged ≥18 years) who were asked to self-complete the ten-item CARE Measure immediately after their clinical encounter with students who provided care under supervision of the teaching staff. The results showed that the CARE Measure demonstrated good internal consistency (Cronbach's α=0.95). A single factor solution emerged, accounting for 69% of the variance. The mean CARE Measure score in the consultations was 43.55±6.14, and 26% of the students achieved the maximum possible score of 50. The mean number of encounters with each student was 2.33±2.78. An increase of one episode was associated with an insignificant average CARE score decrease of 0.05 (-0.28, 0.38), whereas students' empathy was associated with a small increase in average CARE Measure score of 0.63 (0.08, 1.18). These results provide evidence of the measure's ability to support feedback to dental students on their empathy when interacting with patients.

  6. Maintaining dental education and specialist dental care during an outbreak of a new coronavirus infection. Part 1: a deadly viral epidemic begins.

    Science.gov (United States)

    Smales, F C; Samaranyake, L P

    2003-11-22

    During the three months from March 2003 the economically vibrant city of Hong Kong was seriously dislocated after becoming 'second port of call' of the new and potentially fatal disease, Severe Acute Respiratory Syndrome (SARS). The uncertainties during that period had a significant impact on the provision of dental care. However the city's only dental hospital continued to function and to support the Faculty of Dentistry of the University of Hong Kong in educating dental students and other members of the dental team. At the time of writing no transmissions of the disease have been attributed to procedures associated with dental healthcare. This article chronicles the sequence of events during the outbreak from a dental perspective. It highlights information that may be useful to dental colleagues who might someday be confronted with similar outbreaks of newly emerged potentially lethal infections.

  7. Access to Care and Depression among Emergency Department Patients.

    Science.gov (United States)

    Abar, Beau; Hong, Steven; Aaserude, Eric; Holub, Ashley; DeRienzo, Vincent

    2017-07-01

    The prevalence of depression among patients in the emergency department (ED) is significantly higher than in the general population, making the ED a potentially important forum for the identification of depression and intervention. Concomitant to the identification of depression is the issue of patient access to appropriate care. This study sought to establish prevalence estimates of potential barriers to care among ED patients and relate these barriers with symptoms of depression. Two medical students conducted brief surveys on all ED patients ≥ 18 years on demographics, perceived access to care, and depression. A total of 636 participants were enrolled. The percentage of participants with mild or greater depression was 42%. The majority of patients reported experiencing some barriers to care, with the most prominent being difficulty finding transportation, work responsibilities, and the feeling that the doctor is not responsive to their concerns. Higher depression scores were bivariately associated with higher overall barriers to care mean scores (r = 0.44; p patients' concerns, embarrassment about a potential illness, and confusion trying to schedule an appointment. Across all barriers analyzed, there was a greater incidence of depression associated with a greater perception of barriers. These barriers may be used as potential targets for intervention to increase access to health care resources. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Getting help for children: the need to expand the dental workforce.

    Science.gov (United States)

    Gehshan, Shelly; Mijic, Marko

    2011-07-01

    Millions of children in America suffer from poor oral health due to lack of access to dental care. The landmark U.S. Surgeon General's Report in 2000 highlighted significant disparities, yet poor oral health remains an epidemic. America's system of delivering dental care is poorly equipped to address access disparities. However, opportunities abound to improve access and expand the dental workforce. Creative thinking and innovative solutions are needed to expand care to children in need.

  9. Geographic access to gynecologic cancer care in the United States.

    Science.gov (United States)

    Shalowitz, David I; Vinograd, Alexandra M; Giuntoli, Robert L

    2015-07-01

    Women who live distant from the closest subspecialty treatment center are at risk of failing to utilize high-quality care for gynecologic cancers. There has not yet been a comprehensive, national investigation of populations affected by geographic barriers to gynecologic cancer care. Geographic Information Systems (GIS) were used to identify United States counties farther than 50miles from the closest gynecologic oncologist, and hospital referral regions (HRRs) that do not contain the primary professional address of at least one gynecologic oncologist. US Census data were used to analyze counties' demographic characteristics. County-level cancer incidence was estimated using the Centers for Disease Control and Prevention's State Cancer Profiles. Thirty-six percent (1125/3143) of counties are further than 50miles from the nearest gynecologic oncologist. A total of 14.8 million women live in low-access counties (LACs). Annually, approximately 7663 women with gynecologic cancers may experience geography-related disparities in access. Residents of LACs have lower median household income, are more likely to be White and/or Hispanic, and less likely to be Black. Forty percent (123/306) of HRRs do not contain the primary address of a gynecologic oncologist. Approximately 9% of the female population of the United States may experience geographic barriers to access high-quality care for gynecologic malignancies. Future investigations should assess whether residents of low-access counties utilize high-quality care less often, and whether there is a disparity in clinical outcomes. Disparities might be addressed by ensuring subspecialty care in low-access regions, and/or adjusting system structures to minimize the burdens of traveling long distances for cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Frequency of nursing care of vascular access in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Iman Taghizade Firoozjayi

    2016-03-01

    Full Text Available Background: Hemodialysis is a critical treatment method, which depends on the vascular access route. Lack of care for the vascular access route could diminish its efficiency in a short time. Regarding this, the present study aimed to evaluate the frequency of nursing care for vascular access route in the hemodialysis patients. Methods: This cross-sectional study was conducted on 20 nurses and 120 hemodialysis patients, who referred to the Hemodialysis Department of Shahid Beheshti Hospital, Babol, Iran, in 2015. The method of nursing care for vascular access route was evaluated using a researcher-made checklist. The data analysis was performed using the descriptive statistics in the SPSS version 16. Results: In total, 14 cases of nursing care were evaluated, in 100% of which all the caring steps, including wearing gloves and a mask, early bolus injections of heparin, washing the catheter tubing, frequent monitoring of blood pressure, rinsing the catheter tubing, returning the blood to the body after hemodialysis, and sterile covering of the puncture site, were observed. However, some of the other techniques, such as the care related to appropriate pump speed when starting the dialysis machine (81.66%, observance of the needle distance from fistula (75.83%, appropriate placement of catheter (75%, pressing the injection site (54.17%, blood pressure monitoring at the end of dialysis (50%, and change of the needle site between two sessions (27.5%, were not adhered to by the nurses. Conclusion: According to the results of this study, some of the nursing care steps, which are necessary in the beginning and end of the hemodialysis, were not accurately followed by the nurses. It is recommended that constant training courses be held for the nurses in this regard.

  11. [How do asylum seekers experience access to medical care?

    Science.gov (United States)

    Spura, Anke; Kleinke, Matthias; Robra, Bernt-Peter; Ladebeck, Nadine

    2017-04-01

    In Germany basic medical care for asylum seekers is organized outside the statutory health insurance system. Currently there are few empirically based statements on how asylum seekers experience their access to healthcare. The aim is therefore to evaluate their experiences with healthcare focussing on subjective health, utilisation and access to medical care, and experiences with medical care. Between August and November 2015, we performed 16 qualitative problem-oriented guided interviews with asylum seekers, who received or sought medical care in Saxony-Anhalt. The interpreter-assisted interviews were evaluated with content analysis. Access begins with a voucher for medical treatment issued by the social security office. Asylum seekers experience that procedure as onerous and incapacitating. These experiences influence subjective health and utilisation of medical help. If their efforts for treatment certificates are rejected, people increasingly resign. If medical treatment is achieved, they experience medical staff mostly as competent and friendly, in spite of language difficulties and time pressure. Reducing the "voucher bureaucracy" by uniform rules and practices may bring about a relief to access and utilisation of healthcare. Introducing an electronic health insurance card for asylum seekers would retransfer decision making about treatment needs from the welfare system into the medical system.

  12. Advanced access: reducing waiting and delays in primary care.

    Science.gov (United States)

    Murray, Mark; Berwick, Donald M

    2003-02-26

    Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

  13. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

    Science.gov (United States)

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  14. Dental care protocol based on visual supports for children with autism spectrum disorders

    OpenAIRE

    2015-01-01

    Background Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments. Material and Methods 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in...

  15. Negotiating candidacy: ethnic minority seniors' access to care.

    Science.gov (United States)

    Koehn, Sharon

    2009-05-01

    The 'Barriers to Access to Care for Ethnic Minority Seniors ' (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of 'candidacy', which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

  16. Quality of Health Insurance Coverage and Access to Care for Children in Low-Income Families.

    Science.gov (United States)

    Kreider, Amanda R; French, Benjamin; Aysola, Jaya; Saloner, Brendan; Noonan, Kathleen G; Rubin, David M

    2016-01-01

    An increasing diversity of children's health coverage options under the US Patient Protection and Affordable Care Act, together with uncertainty regarding reauthorization of the Children's Health Insurance Program (CHIP) beyond 2017, merits renewed attention on the quality of these options for children. To compare health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. A repeated cross-sectional analysis was conducted using data from the 2003, 2007, and 2011-2012 US National Surveys of Children's Health, comprising 80,655 children 17 years or younger, weighted to 67 million children nationally, with household incomes between 100% and 300% of the federal poverty level. Multivariable logistic regression models compared caregiver-reported outcomes across insurance types. Analysis was conducted between July 14, 2014, and May 6, 2015. Insurance type was ascertained using a caregiver-reported measure of insurance status and each household's poverty status (percentage of the federal poverty level). Caregiver-reported outcomes related to access to primary and specialty care, unmet needs, out-of-pocket costs, care coordination, and satisfaction with care. Among the 80,655 children, 51,123 (57.3%) had private insurance, 11,853 (13.6%) had Medicaid, 9554 (18.4%) had CHIP, and 8125 (10.8%) were uninsured. In a multivariable logistic regression model (with results reported as adjusted probabilities [95% CIs]), children insured by Medicaid and CHIP were significantly more likely to receive a preventive medical (Medicaid, 88% [86%-89%]; P < .01; CHIP, 88% [87%-89%]; P < .01) and dental (Medicaid, 80% [78%-81%]; P < .01; CHIP, 77% [76%-79%]; P < .01) visits than were privately insured children (medical, 83% [82%-84%]; dental, 73% [72%-74%]). Children with all insurance types experienced challenges in access to specialty care, with caregivers of children

  17. A New Approach to Ensuring Oral Health Care for People Living With HIV/AIDS: The Dental Case Manager

    OpenAIRE

    Lemay, Celeste A.; Cashman, Suzanne B.; McDonald, Anne; Graves, John R.

    2012-01-01

    Introduction The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health. Methods We used a qualitative descriptive study design and focus groups. Twenty-five pe...

  18. Patient satisfaction analysis on service quality of dental health care based on empathy and responsiveness

    Science.gov (United States)

    Dewi, Fellani Danasra; Sudjana, Grita; Oesman, Yevis Marty

    2011-01-01

    Background: Transformation of health care is underway from sellers’ market to consumers’ market, where the satisfaction of the patients’ need is a primary concern while defining the service quality. Hence, commitment to provide a high-quality service and achieving patients’ satisfaction becomes an important issue for dental health care provider. The aim of this research is to investigate the quality of dental health care service based on empathy and responsiveness aspects. Methods: A total of 90 questionnaires were completed by the dental patients who came to dental polyclinic located in Government Hospital, West Java, Indonesia. The questionnaire was concerned on two dimensions of service quality model, i.e. empathy and responsiveness. The obtained data were analyzed using inferential statistics (t test) and also descriptive statistics with importance–performance analysis. Results: All the attributes tested by t test showed that perception and expectation differed significantly, except for responsiveness, i.e. ability of dental assistants in assisting the dentist (t test 0.505dentist (t test 4.700). Conclusion: It can be inferred from IPA that priority should be given to dentist's communication and dental assistant's knowledge toward patient's needs to enhance the service quality. PMID:22135687

  19. Future demand for dental care in Norway; a macro-economic perspective.

    Science.gov (United States)

    Grytten, J; Lund, E

    1999-10-01

    The future demand for dental care in Norway is discussed on the basis of economic theory. During the next 30 years gross national income will increase substantially due to a marked increase in national income from the sale of oil and gas. On the basis of the model we predict that this increase in income will lead to an increase in demand for dental services in the short run, say for the next 10-15 years. To a large extent this increase in demand is supported by evidence from dental epidemiology. In particular, an increasing proportion of elderly dentate people will demand more services. This picture is different in the long run, say from the year 2010-15 and onwards. Evidence from dental epidemiology indicates that at that stage there will be a fairly high proportion of disease-free individuals in the population who will demand less dental care. Such a trend is also supported by economic theory as long as disease-free individuals consume less dental care irrespective of their income.

  20. A Cognitive Behavioural Intervention for Dental Anxiety for People with Learning Disabilities: A Case Study

    Science.gov (United States)

    Prangnell, Simon J.; Green, Karen

    2008-01-01

    Dental anxiety is a common form of anxiety problem, and research suggests that more people with learning disabilities experience dental anxiety than in the general population. Very little work has been done to investigate effective non-medical approaches for supporting people with a learning disability and dental anxiety to access dental care.…

  1. Fear of deportation is not associated with medical or dental care use among Mexican-origin farmworkers served by a federally-qualified health center--faith-based partnership: an exploratory study.

    Science.gov (United States)

    López-Cevallos, Daniel F; Lee, Junghee; Donlan, William

    2014-08-01

    Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services.

  2. Measuring access to primary health care: use of a GIS-based accessibility analysis (conference paper)

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-10-01

    Full Text Available Spatial analytical tools and analyses are key enabling instruments which can be used to efficiently plan for public-spaces such as health care facilities in a metropolitan context. Improving the levels of access to public-spaces through various...

  3. Examining whether dental therapists constitute a disruptive innovation in US dentistry.

    Science.gov (United States)

    Edelstein, Burton L

    2011-10-01

    Dental therapists-midlevel dental providers who are roughly analogous to nurse practitioners in medicine-might constitute a disruptive innovation within US dentistry. Proponents tend to claim that dental therapists will provide more equitable access to dental care; opponents tend to view them from a perspective that focuses on retaining the current attributes of the dental profession. Therapists display traits similar to those of disruptive innovations: their attributes are different from dentists', they may not initially be valued by current dental patients, they may appeal to current dental underutilizers, and they may transform the dental delivery system. Whether dental therapists constitute a disruptive innovation will only be determined retrospectively.

  4. [Nursing ethics and the access to nursing care].

    Science.gov (United States)

    Monteverde, Settimio

    2013-08-01

    The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.

  5. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care.

    Science.gov (United States)

    Andersen, Lotte Bøgh; Bech, Mickael; Lauridsen, Jørgen

    2012-07-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying spatial patterns in expenditure levels across municipalities, we are able to test the influences of these two main actors and the networks through which learning is achieved. Four hypotheses on the existence of different spatial spillover effects are tested. The empirical analysis is based on annual data from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore, dentists appear to be the most important actors for the spatial spillover effects, and these effects are especially strong for municipalities situated in the same county that use private dental clinics. There is no evidence of political spatial spillover effects between municipalities.

  6. Public finance policy strategies to increase access to preconception care.

    Science.gov (United States)

    Johnson, Kay A

    2006-09-01

    Policy and finance barriers reduce access to preconception care and, reportedly, limit professional practice changes that would improve the availability of needed services. Millions of women of childbearing age (15-44) lack adequate health coverage (i.e., uninsured or underinsured), and others live in medically underserved areas. Service delivery fragmentation and lack of professional guidelines are additional barriers. This paper reviews barriers and opportunities for financing preconception care, based on a review and analysis of state and federal policies. We describe states' experiences with and opportunities to improve health coverage, through public programs such as Medicaid, Medicaid waivers, and the State Children's Health Insurance Program (SCHIP). The potential role of Title V and of community health centers in providing primary and preventive care to women also is discussed. In these and other public health and health coverage programs, opportunities exist to finance preconception care for low-income women. Three major policy directions are discussed. To increase access to preconception care among women of childbearing age, the federal and state governments have opportunities to: (1) improve health care coverage, (2) increase the supply of publicly subsidized health clinics, and (3) direct delivery of preconception screening and interventions in the context of public health programs.

  7. Is primary care access to CT brain examinations effective?

    Energy Technology Data Exchange (ETDEWEB)

    Benamore, R.E. [Department of Radiology, Pilgrim Hospital, Boston (United Kingdom)]. E-mail: rachelbenamore@doctors.org.uk; Wright, D. [Department of Radiology, Pilgrim Hospital, Boston (United Kingdom); Britton, I. [Department of Radiology, Pilgrim Hospital, Boston (United Kingdom)

    2005-10-01

    AIM: Primary care access to CT head examinations could enable common neurological conditions to be managed within primary care. Outcome data from the first 8 years of a local service were used to identify effective referral criteria. METHODS: Primary care head CT results from 1 March 1995 to 31 October 2003 were categorized as normal, incidental or significant findings. Normal reports were cross-referenced for referral to secondary care. Case notes with incidental or significant CT findings were reviewed for secondary care attendance and outcome. RESULTS: Records of 1403/1645 CT head examinations (85%) were available for review. Of these 1403, 951 (67.8%) returned normal findings, 317 (22.6%) incidental findings and 135 (9.6%) significant findings. The commonest indication for referral was investigation of headaches (46.6%). Of the total 533 patients under 50 years of age, 13 (2.4%) yielded significant findings and all 13 showed other features in addition to headache. Of 314 cases presenting with focal neurology, 83 (26.4%) showed significant findings. 314 patients were referred from primary to secondary care. 189 had normal scans and 74 had findings described as incidental. 60% of secondary care referrals were for normal CT scans. In patients with focal neurology, 90 of 314 were referred, allowing 71% to be managed in primary care. Yield was also 0% for headaches, dizziness, visual disturbance or nausea and vomiting. CONCLUSION: Primary care access to CT brain examinations is effective for patients with focal neurology, neurological symptoms or a known malignancy, but not for patients aged less than 50 years, or with uncomplicated headaches, dizziness or diplopia.

  8. Effect of health insurance type on access to care.

    Science.gov (United States)

    Froelich, John M; Beck, Ryan; Novicoff, Wendy M; Saleh, K J

    2013-10-01

    Growing orthopedic and nonorthopedic literature illustrates the point that having health insurance does not equal having access to care. The goal of this study was to evaluate the burden placed on patients to gain access to outpatient orthopedic care. For this study, burden was quantified as the distance traveled by the patient to be seen in clinic. This study was a retrospective review of all new patient encounters at an adult orthopedic outpatient clinic in an academic tertiary referral center over 1 calendar year. All patients were stratified into 4 categories: commercial/private insurance, Medic-aid, Medicare, and uninsured/private pay. The average distance traveled by each patient to the center was then calculated based on the patient's billing zip code. Patient visits were further stratified based on whether the patients were seen by 1 of 3 different categories of providers: general orthopedics/adult reconstruction, spine, and sports/upper extremity. The study group comprised 774 (31.1%) Medicaid patients, 653 (26.2%) Medicare patients, 917 (36.8%) commercial/private insurance patients, and 146 (5.9%) uninsured/private pay patients. The average 1-way distance traveled was 36.2 miles for Medicaid patients, 21.3 miles for Medicare patients, 24.1 miles for commercial/private insurance patients, and 25.3 miles for uninsured/private pay patients (Paccess to outpatient orthopedic care at a single institution. The specific burdens that each group faces to gain access to care are unclear.

  9. Unmet Dental Needs and Barriers to Dental Care among Children with Autism Spectrum Disorders

    Science.gov (United States)

    Lai, Bien; Milano, Michael; Roberts, Michael W.; Hooper, Stephen R.

    2012-01-01

    Mail-in pilot-tested questionnaires were sent to a stratified random sample of 1,500 families from the North Carolina Autism Registry. Multivariate logistic regression analysis was used to determine the significance of unmet dental needs and other predictors. Of 568 surveys returned (Response Rate = 38%), 555 were complete and usable. Sixty-five…

  10. Unmet Dental Needs and Barriers to Dental Care among Children with Autism Spectrum Disorders

    Science.gov (United States)

    Lai, Bien; Milano, Michael; Roberts, Michael W.; Hooper, Stephen R.

    2012-01-01

    Mail-in pilot-tested questionnaires were sent to a stratified random sample of 1,500 families from the North Carolina Autism Registry. Multivariate logistic regression analysis was used to determine the significance of unmet dental needs and other predictors. Of 568 surveys returned (Response Rate = 38%), 555 were complete and usable. Sixty-five…

  11. Encouraging Consumption of Water in School and Child Care Settings: Access, Challenges, and Strategies for Improvement

    Science.gov (United States)

    Hampton, Karla E.

    2011-01-01

    Children and adolescents are not consuming enough water, instead opting for sugar-sweetened beverages (sodas, sports and energy drinks, milks, coffees, and fruit-flavored drinks with added sugars), 100% fruit juice, and other beverages. Drinking sufficient amounts of water can lead to improved weight status, reduced dental caries, and improved cognition among children and adolescents. Because children spend most of their day at school and in child care, ensuring that safe, potable drinking water is available in these settings is a fundamental public health measure. We sought to identify challenges that limit access to drinking water; opportunities, including promising practices, to increase drinking water availability and consumption; and future research, policy efforts, and funding needed in this area. PMID:21680941

  12. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands.

    Science.gov (United States)

    Schoevers, Marianne A; Loeffen, Maartje J; van den Muijsenbergh, Maria E; Lagro-Janssen, Antoine L M

    2010-10-01

    To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09-0.90) reduces utilisation of primary health care services. Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help.

  13. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands.

    NARCIS (Netherlands)

    Schoevers, M.A.; Loeffen, M.J.; Muijsenbergh, M.E.T.C. van den; Lagro-Janssen, A.L.M.

    2010-01-01

    OBJECTIVE: To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. METHODS: A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a

  14. Knowledge and attitudes of Japanese dental health care workers towards HIV-related disease.

    Science.gov (United States)

    Kitaura, H; Adachi, N; Kobayashi, K; Yamada, T

    1997-01-01

    The present study was undertaken to investigate knowledge of AIDS and HIV infection among Japanese dental health care workers, the source of that knowledge and attitudes of dental workers towards infected patients. The study population surveyed by means of a self-administered questionnaire consisted of 174 dental health workers at Nagasaki University Dental Hospital, including students and trainee hygienists. Most respondents (100% response) claimed their major source of AIDS knowledge to be derived from the media. Almost all considered their knowledge of AIDS and HIV infection to be more than moderate but still inadequate. The majority of respondents would be hesitant about performing dental treatment on HIV-positive patients. It was widely anticipated that dental patients infected with HIV would increase in the next few years and many were anxious about the increasing occupational risk of HIV infection. Only 22.4% of respondents had the same attitude towards treating HIV-positive and HIV-negative patients. Most also considered that they would be able to take care of the oral opportunistic diseases associated with HIV. Over 90.0% of respondents requested additional education about HIV, particularly information about the prevention and spread of the virus and cross-infection requirements. It is concluded that further training in the medical and psychological aspects of treating HIV-positive patients is indicated in Japan.

  15. Models for Delivering School-Based Dental Care.

    Science.gov (United States)

    Albert, David A.; McManus, Joseph M.; Mitchell, Dennis A.

    2005-01-01

    School-based health centers (SBHCs) often are located in high-need schools and communities. Dental service is frequently an addition to existing comprehensive services, functioning in a variety of models, configurations, and locations. SBHCs are indicated when parents have limited financial resources or inadequate health insurance, limiting…

  16. Dental Care Issues for African Immigrant Families of Preschoolers

    Science.gov (United States)

    Obeng, Cecilia S.

    2008-01-01

    This article examines dental health issues for African immigrant families of preschoolers living in the United States. The study was done within the framework of narrative inquiry and ethnographic impressionism. Through personal interviews and questionnaire completion, 125 parents of children ages 3 to 5 answered questions about ways in which…

  17. Dental care needs in the child population of a megapolis

    Directory of Open Access Journals (Sweden)

    S. B. Ulitovskiy

    2015-01-01

    Full Text Available Based on the reports of examination preschool and school-aged children for the 2008-2014 year we can conclude that nowadays the issue of prevention of dental diseases among the inspected groups of children is actually

  18. Questionnaire for measuring organisational attributes in dental-care practices: psychometric properties and test-retest reliability.

    Science.gov (United States)

    Goetz, Katja; Hasse, Philipp; Szecsenyi, Joachim; Campbell, Stephen M

    2016-04-01

    The consideration of organisational aspects, such as shared goals and clear communication, within the health care team is important to ensure good quality care. In primary health care, the instrument Survey of Organizational Attributes for Primary Care (SOAPC) is available to measure organisational attributes of care. However, there is no instrument available for dental care. The aim of the present study was to investigate psychometric properties and test-retest reliability of the version of SOAPC adapted for dental care, namely the Survey of Organizational Attributes in Dental Care (SOADC). The SOADC consists of 21 items in the following four subscales: communication; decision making; stress/chaos; and history of change. Convergent construct validity was measured using the job satisfaction scale. A total of 287 dental-care practices were asked to participate in the validation study. Psychometric properties and test-retest reliability were observed. A total of 43 dental-care practices responded to the survey. At baseline, 178 dental-care staff completed the questionnaire, and 4 weeks later 138 did so. Internal consistency, measured by Cronbach's alpha, was 0.718 or higher in the subscales. The test-retest reliability for each subscale and the overall SOADC score demonstrated good correlations over the 4-week test-retest interval, except for 'history of change'. A strong correlation with the aggregated job-satisfaction scale showed high convergent construct validity of SOADC. The consideration of organisational aspects from the perspective of dental-care teams is important for providing good quality of care. The SOADC is a reliable instrument with good psychometric properties and is suitable for the evaluation of organisational attributes in dental-care practices. © 2015 FDI World Dental Federation.

  19. Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

    Science.gov (United States)

    Cornejo-Ovalle, Marco; Paraje, Guillermo; Vásquez-Lavín, Felipe; Pérez, Glòria; Palència, Laia; Borrell, Carme

    2015-01-01

    The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20–39, 40–59, 60–63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage. PMID:25749319

  20. Demand for orthodontic treatment among 9-18 year-olds seeking dental care in Dar-es-Salaam, Tanzania.

    NARCIS (Netherlands)

    Mugonzibwa, E.A.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Kikwilu, E.

    2004-01-01

    OBJECTIVE: To investigate the demand for orthodontic treatment among 9-18 olds seeking dental care in Dar-es-Salaam, Tanzania. DESIGN: Case-control, interview and clinical study. SETTINGS: Children seeking dental care. MAIN OUTCOME MEASURES: Demand for orthodontic treatment. RESULTS: Most of the chi

  1. Evaluation of advanced access in the national primary care collaborative.

    Science.gov (United States)

    Pickin, Mark; O'Cathain, Alicia; Sampson, Fiona C; Dixon, Simon

    2004-05-01

    An aim of the National Primary Care Collaborative is to improve quality and access for patients in primary care using principles of Advanced Access. To determine whether Advanced Access led to improved availability of appointments with general practitioners (GPs) and to examine GPs' views of the process. Observational study. Four hundred and sixty-two general practices in England participating in four waves of the collaborative during 2000 and 2001. Regression analysis of the collaborative's monthly data on the availability of GP appointments for the 352 practices in waves 1-3, and a postal survey of lead GPs in all four waves. The main outcome measures were the change in mean time to the third available appointment with GPs, and the proportion of GPs thinking it worthwhile participating in the collaborative. The time to the third available appointment improved from a mean of 3.6 to 1.9 days, difference = 1.7 days, 95% confidence interval (CI)= 1.4 to 2.0 days. It improved in two-thirds of practices (66% [219/331]), remained the same in 16% (53/331), and worsened in 18% (59/331). The majority of GPs in all four waves, 83% (308/371, 95% CI = 79 to 87), felt that it was worthwhile participating in the collaborative, although one in 12 practices would not recommend it. One-fifth of GPs cited a lack of resources as a constraint, and some expressed concerns about the trade-off between immediate access and continuity of care. Advanced Access helped practices to improve availability of GP appointments, and was well received by the majority of practices.

  2. High educational attainment moderates the association between dental health-care supply and utilization in Europe.

    Science.gov (United States)

    Schulz, Maike; Kunst, Anton E; Brockmann, Hilke

    2016-02-01

    In line with the theory of supplier-induced demand, an increased physician density often goes along with a higher utilization of medical services, including dental services. This study aimed to assess whether dentist density and self-employment are related to dental care use, and whether these relationships are moderated by patients' educational attainment. We used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from over 20,000 respondents, 50 + yr of age, in 13 countries. We conducted multilevel logistic regressions with probability and type of dental treatment on individual education, country-specific dentist density, and dentist remuneration, and their cross-level interaction. Patients with a high educational level were more likely to report a dentist visit (OR = 2.1, 95% CI: 1.912-2.305) and to receive preventive care (OR = 1.9, 95% CI: 1.697-2.043) than those with a low educational level (reference category). Cross-level interaction effects indicated that high dentist density decreases dental care utilization differences between patients with high (OR = 0.996, 95% CI: 0.993-0.999), medium (OR = 0.995, 95% CI: 0.991-0.999), and low education levels. This was also true for prevention use (OR = 0.996, 95% CI: 0.992-0.999 for patients with a high education level, and OR = 0.996, 95% CI: 0.993-1.000 for patients with a medium education level). The findings suggest that although dentist density is positively associated with dental care utilization, patients have differing susceptibilities to dental care supply.

  3. Deported Mexican migrants: health status and access to care

    Science.gov (United States)

    Fernández-Niño, Julián Alfredo; Ramírez-Valdés, Carlos Jacobo; Cerecero-Garcia, Diego; Bojorquez-Chapela, Ietza

    2014-01-01

    OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico’s Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required. PMID:25119943

  4. Health Care Access and Utilization after the 2010 Pakistan Floods.

    Science.gov (United States)

    Jacquet, Gabrielle A; Kirsch, Thomas; Durrani, Aqsa; Sauer, Lauren; Doocy, Shannon

    2016-10-01

    Introduction The 2010 floods submerged more than one-fifth of Pakistan's land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks. Hypothesis Damage and loss of critical infrastructure will affect the population's ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods. A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance. A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (Pfloods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses. Jacquet GA , Kirsch T , Durrani A , Sauer L , Doocy S . Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485-491.

  5. Clinical profile of orofacial infections: An experience from two primary care dental practices

    Science.gov (United States)

    Hollinshead, Frank

    2012-01-01

    Objectives: Orofacial infections are common reasons for dental consultations worldwide. However, there is scarcity of data on clinico-epidemiological profiles reported from primary care dental practices. To address this issue, a study was done to characterize the clinical pattern, age groups affected and sex predilection of orofacial infections in the primary care dental practice. Study design: Clinical data was evaluated from random electronic files of patients for whom antimicrobials were prescribed at two Dental Practices in UK between January 2009 and December 2010. Results: 200 case records were studied. 104 (52%) cases were females. Mean age was 37.2 (+/-15.1) years. 107 (53.5%) cases belonged to age group 21-40 years. Posterior teeth were involved in 112 (56%) cases. Types of disease were as follows: dentoalveolar abscess 63(31.5%), pulpitis 27(13.5%), apical periodontitis 21(10.5%), pericoronitis 21(10.5%), dry socket 13(6.5%), periodontitis 9(4.5%) infected root stump 5(2.5%), facial swelling 5(2.5%) and infections unspecified 36(18%) cases. Conclusions: Orofacial infections affect both sexes equally. 21-40 years is the commonest age-group affected. Dentoalveolar abscess is the commonest infection followed by unspecified infections and pulpitis. Key words:Orofacial infections, primary care dental practice, dentoalveolar abscess and pulpitis. PMID:22322492

  6. Structure of non-reimbursed and reimbursed therapeutic procedures provided at a general dental care office

    Directory of Open Access Journals (Sweden)

    Zgardzinska Sylwia

    2014-09-01

    Full Text Available Dental care in Poland is based both on the public system (reimbursement by the National Health Fund and on the private funding (non-reimbursed. The aim of the paper was an analysis of the structure of non-reimbursed and reimbursed therapeutic procedures provided at a general dental care office. The study material was medical documentation of 669 patients treated for 3 months (the third quarter of 2013 at a general dental care office. The structure of therapeutic procedures, with the exception of orthodontic and prosthetic treatment, was analyzed, taking into account the patients’ gender, age, place of residence, the kind of procedure, and the payment type they made. The procedures reimbursed by the National Health Fund constituted 60.1% of all the procedures provided to patients at a dental office. Both among the procedures reimbursed by the National Health Fund and non-reimbursed procedures, the therapeutic procedures prevailed significantly over the prophylactic ones; in all age groups conservative treatment was predominant. An increase in the number of extractions in patients over 40 years of age, in comparison to younger patients, was found. The number of the dental procedures reimbursed by the National Health Fund, compared to the number of the non-reimbursed ones, increased with the patients’ age.

  7. Access to health care and diagnosis of tuberculosis

    Directory of Open Access Journals (Sweden)

    Dândara Nayara Azevêdo Dantas

    2014-12-01

    Full Text Available The objective was to know the evaluation of patients with tuberculosis regarding the access to health care and the diagnosis of the disease. It is a cross-sectional quantitative study made in Natal, RN, Brazil, from February to September 2012, with 60 patients diagnosed with tuberculosis. Data were collected using a questionnaire and analyzed using descriptive statistics. Access to health care was considered easy by 80% of patients. Of those, 35% considered it easy because of the short time to get a doctor’s appointment and 21.7% because of their relationship with the health professionals. The access to the diagnosis of the disease was also evaluated as easy (85%. Of this total, 33.3% rated it as easy, once the exams were made in the health service and 13.3% due to the short time to get immediate doctor’s appointment. It is concluded that the organization of the services was crucial for the good or bad evaluation of the access to the assistance to health and diagnosis of the disease.

  8. Investigating impacts of positional error on potential health care accessibility.

    Science.gov (United States)

    Bell, Scott; Wilson, Kathi; Shah, Tayyab Ikram; Gersher, Sarina; Elliott, Tina

    2012-04-01

    Accessibility to health services at the local or community level is an effective approach to measuring health care delivery in various constituencies in Canada and the United States. GIS and spatial methods play an important role in measuring potential access to health services. The Three-Step Floating Catchment Area (3SFCA) method is a GIS based procedure developed to calculate potential (spatial) accessibility as a ratio of primary health care (PHC) providers to the surrounding population in urban settings. This method uses PHC provider locations in textual/address format supplied by local, regional, or national health authorities. An automated geocoding procedure is normally used to convert such addresses to a pair of geographic coordinates. The accuracy of geocoding depends on the type of reference data and the amount of value-added effort applied. This research investigates the success and accuracy of six geocoding methods as well as how geocoding error affects the 3SFCA method. ArcGIS software is used for geocoding and spatial accessibility estimation. Results will focus on two implications of geocoding: (1) the success and accuracy of different automated and value-added geocoding; and (2) the implications of these geocoding methods for GIS-based methods that generalise results based on location data.

  9. Self-Reported Obstacles to Regular Dental Care among Information Technology Professionals

    Science.gov (United States)

    Reddy, L. Swetha; Reddy, B. Srikanth; Kulkarni, Suhas; Reddy, M. Padma; Satyanarayana, D.; Baldava, Pavan

    2016-01-01

    Introduction Good oral health is important for an individual as well as social well-being. Occupational stress and work exhaustion in Information Technology (IT) professionals may influence the oral health and oral health related quality of life. Aim To assess and compare self-reported obstacles for regular dental care and dental visits among IT professionals based on age, gender, dental insurance and working days per week. Materials and Methods A cross-sectional study was conducted among 1,017 IT professionals to assess the self-reported obstacles to regular oral health care in Hyderabad city, Telangana, India. The Dental Rejection of Innovation Scale (DRI-S) was employed in this study. Comparison between means of DRI-S based on variables was done using t-test and ANOVA. The association between variables and DRI-S was determined using Chi-square test. Results A total of 1017 participants comprising of 574 (56%) males and 443 (44%) females participated in the study. As age increased, a significant increase in mean DRI-S scores was seen for total and individual domains except for the “Situational” domain wherein higher mean score (9.42±2.5; p=0.0006) was observed among 30–39 years age group. Even though females reported higher mean scores for total and individual domains when compared to males, nevertheless significant difference was seen only for total (p=0.03) and “Lack of Knowledge” (p=0.001) domain. Conclusion Self-reported obstacles to regular dental care was more with increasing age, increased number of working days per week, irregular dental visits and absence of dental insurance facility. PMID:27891475

  10. Can midlevel dental providers be a benefit to the American public?

    Science.gov (United States)

    Rodriguez, Tobias E; Galka, Audrey L; Lacy, Ernestine S; Pellegrini, August D; Sweier, Domenica G; Romito, Laura M

    2013-05-01

    The use of midlevel dental providers (MLDPs) is being debated as a means of reducing oral health disparities and increasing access to care among underserved populations. Midlevel dental providers include the advanced dental hygiene practitioner, community dental health coordinator, dental health aide therapist, and dental therapist. While midlevel providers are new to the U.S. dental profession, medicine has utilized these positions for years. Medical literature has shown mixed results as to whether midlevel providers improve access to care and increased practice efficiency, however, it has demonstrated clearly that the quality of care outcomes of these providers have been comparable to those of physicians. Studies of MLDPs suggest potential practice and public health benefits. With appropriate training, licensure, supervision, and deployment to geographical areas of significant need, we believe MLDPs could increase access to care to underserved populations and help in the prevention of deaths attributable to untreated dental disease.

  11. Factors influencing the need for dental care amongst the elderly in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Woods, N

    2009-12-01

    OBJECTIVE: To identify the socio-economic, demographic and behavioural determinants of dental treatment needs of those aged 65 and over in the Republic of Ireland. DESIGN: The treatment needs data is based on detailed clinical oral examinations in the NSAOH carried out between October 2000 and June 2002. To determine factors influencing treatment needs, three measures are used: a dichotomous variable expressing the need for any dental treatment, a dichotomous variable expressing the need for dentures, and a dichotomous variable expressing a Community Periodontal Index of Treatment Need (CPITN) score of three or greater representing a need for periodontal treatment. METHODS: Factors such as age, gender, dental services eligibility status, fluoridation, employment status, educational attainment, anxiety about dental visits, frequency of brushing, and attendance patterns were regressed on a dichotomous version of prevalence of Decayed Missing Filled Surfaces, DMFS including the visual component, and CPITN scores. Associations were estimated using multivariate logistic regression and expressed as odds ratios (OR) with 95% confidence intervals (CI). Goodness of fit was evaluated by estimating sensitivity, specificity, positive\\/negative predictive values and accuracy. RESULTS: Being female, smoking, frequent snacking and anxiety about dental visits increased the odds of having a periodontal treatment need. Having primary education only, and being a smoker increased the odds of having a need for any treatment including dentures, whereas being female, regular usage of dental services, and access to fully fluoridated water supplies reduced the odds. CONCLUSIONS: Socio-economic factors such as lower levels of educational attainment, demographic factors such as age and gender and not having access to fully fluoridated water supplies, and behavioural factors such as smoking, frequent snacking, anxiety about dental visits, influence above average treatment needs amongst the

  12. [Dental care and oral hygiene practices in long-term geriatric care institutions].

    Science.gov (United States)

    Ferreira, Raquel Conceição; Schwambach, Carolina Wolff; de Magalhães, Cláudia Silami; Moreira, Allyson Nogueira

    2011-04-01

    This study evaluated the activities of dentists, dental care and oral hygiene practices in the long-term care institutions of Belo Horizonte (Minas Gerais, Brazil). A semi-structured questionnaire was handed out to the coordinators of 37 philanthropic and 30 private institutions. The data was compared by the chi-square and Fisher's Exact Tests. 81% of the questionnaires were answered. The majority of the private (74.2%) and philanthropic institutions (87%) do not have a dentist (p=0.21). The location, period of existence, type institution kind and number of residents weren't factors regarding the presence of a dentist (p>0.05). 67% of the philanthropic institutions with equipped consultation rooms had dentists, though there were none when there was no consultation room. Even without consultation rooms, 13% of the private institutions had dentists. When necessary, 69.6% of the philanthropic institutions refer the elderly to public health centers, while 58.1% of the private institutions refer them to their family dentists. A higher percentage of the private institutions adopted systematic oral hygiene procedures (p=0.01), with a considerable divergence of treatment reported. There is a need to include a dentist on the health staff in the institutions and for systematization of oral hygiene practices.

  13. Factors affecting utilization of dental care among 6–12-year-old school children in Bangarpet taluk, Karnataka

    Directory of Open Access Journals (Sweden)

    C Priyadarshini

    2015-01-01

    Full Text Available Introduction: Oral diseases qualify as major public health problems owing to their high prevalence and incidence worldwide. Access to oral healthcare refers to patient's ability to obtain or utilize oral healthcare. Aim: To assess the dentition status and treatment needs among 6–12-year-old school children and to assess the factors affecting utilization of dental care among parents. Materials and Methods: A cross-sectional survey was conducted among 420 school children (6–12 years in Bangarpet taluk. Factors affecting utilization of dental care were assessed using a validated questionnaire and dentition status and treatment needs was recorded according to WHO 1997 proforma. Descriptive and inferential statistics were used. Results: The proportion of children with dmft was 62 (30% and 54 (26% in urban and rural children, respectively whereas the proportion of children with DMFT was 48 (23% and 79 (38% in urban and rural children, respectively. Among urban children 99 (47% did not need any treatment when compared to 87 (41% rural children. Around 32 (15.2% needed one surface filling in urban children and 20 (9.52% in rural children. About 30 (14.28% urban and 40 (19.04 in rural children needed preventive care, respectively. Most of the parents were not aware of fluoride content in the toothpaste. Parents agreed that maintenance of oral health is their duty. There was a significant difference between urban and rural parents for the barriers "no time to visit" (P = 0.0002, "affects my work" (P = 0.048 and "scared of injection" (P = 0.0033. Dental visits were found to be low in both urban 37 (18% and rural 56 (27% children. Conclusion: The caries experience was similar among urban and rural children. Most of the children required restorative and preventive care. Fear of injection and lack of time to visit dentist were the major barriers to parents for utilization of dental care. Hence, integrated approach is suggested to strengthen preventive and

  14. Longitudinal behavioral analysis during dental care of children aged 0 to 3 years

    Directory of Open Access Journals (Sweden)

    Robson Frederico Cunha

    2009-09-01

    Full Text Available "When" and "how" the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP, were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.

  15. Access to health care and religion among young American men.

    Science.gov (United States)

    Gillum, R Frank; Jarrett, Nicole; Obisesan, Thomas O

    2009-12-01

    In order to elucidate cultural correlates of utilization of primary health services by young adult men, we investigated religion in which one was raised and service utilization. Using data from a national survey we tested the hypothesis that religion raised predicts access to and utilization of a regular medical care provider, examinations, HIV and other STD testing and counseling at ages 18-44 years in men born between 1958 and 1984. We also hypothesized that religion raised would be more predictive of utilization for Hispanic Americans and non-Hispanic Black Americans than for non-Hispanic White Americans. The study included a national sample of 4276 men aged 18-44 years. Descriptive and multivariate statistics were used to assess the hypotheses using data on religion raised and responses to 14 items assessing health care access and utilization. Compared to those raised in no religion, those raised mainline Protestant were more likely (p Religion raised was not associated with testicular exams, STD counseling or HIV testing. In multivariate analyses controlling for confounders, significant associations of religion raised with insurance coverage, a physician as usual source of care and physical examination remained which varied by race/ethnicity. In conclusion, although religion is a core aspect of culture that deserves further study as a possible determinant of health care utilization, we were not able to document any consistent pattern of significant association even in a population with high rates of religious participation.

  16. Access to health care in the Scandinavian countries: ethical aspects.

    Science.gov (United States)

    Holm, S; Liss, P E; Norheim, O F

    1999-01-01

    The health care systems are fairly similar in the Scandinavian countries. The exact details vary, but in all three countries the system is almost exclusively publicly funded through taxation, and most (or all) hospitals are also publicly owned and managed. The countries also have a fairly strong primary care sector (even though it varies between the countries), with family physicians to various degrees acting as gatekeepers to specialist services. In Denmark most of the GP services are free. For the patient in Norway and Sweden there are out-of-pocket co-payments for GP consultations, with upper limits, but consultations for children are free. Hospital treatment is free in Denmark while the other countries use a system with out-of-pocket co-payment. There is a very strong public commitment to access to high quality health care for all. Solidarity and equality form the ideological basis for the Scandinavian welfare state. Means testing, for instance, has been widely rejected in the Scandinavian countries on the grounds that public services should not stigmatise any particular group. Solidarity also means devoting special consideration to the needs of those who have less chance than others of making their voices heard or exercising their rights. Issues of limited access are now, however, challenging the thinking about a health care system based on solidarity.

  17. Open-Access Single Balloon Enteroscopy: A Tertiary Care Experience.

    Science.gov (United States)

    Holman, Nathan; Wallace, Kristin; Moore, J Matthew; Brock, Andrew S

    2015-12-01

    To compare single balloon enteroscopy (SBE) between patients seen in consultation by a member of our gastroenterology team with those performed as open-access cases. Retrospective study of all patients who underwent SBE at a single tertiary care center from April 2008 to January 2012. Open- and closed-access procedures were compared in terms of diagnostic and therapeutic yield, adverse events, and procedural success. A total of 125 SBEs were performed on 125 patients. The mean age was 63.1 (53% men) years. In all, 43 procedures were performed open access and 82 after face-to-face consultation. Indications included anemia/gastrointestinal bleeding (110), abdominal pain (8), and other (7). Diagnostic yield for open- and closed-access procedures was 53% and 60%, respectively (P = 0.501) and therapeutic yield was 37% and 52%, respectively (P = 0.11). Overall technical success was 91% with no difference between the groups (P = 0.27). There were no major adverse events in either group. SBE can be performed as an open-access procedure without compromise to safety or diagnostic yield.

  18. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State assurance of access to care and procedures to assure quality and appropriateness of care. 457.495 Section 457.495 Public Health CENTERS FOR MEDICARE... State assurance of access to care and procedures to assure quality and appropriateness of care. A...

  19. Prevalence and clinical characteristics of headache in dental students of a tertiary care teaching dental hospital in Northern India

    Directory of Open Access Journals (Sweden)

    Ruchika Nandha

    2013-02-01

    Full Text Available Background: Chronic headache is as much as a problem in India as elsewhere in the world with a rising trend in young adults which negatively affects the quality of life of the affected person. In current scenario of increasing prevalence of headache in students, most of them have been found to practice self medication leading to inappropriate management and sometimes analgesic overuse causing treatment refractoriness. Methods: A questionnaire based survey was done on undergraduate dental students at a tertiary care dental teaching hospital in Northern India. Severity of headache was assessed by Numeric Rating Scale. Data collected was analyzed to assess the prevalence, pattern & triggering factors of headache along with awareness of dental students regarding treatment. Prevalence and characteristics of migraine were also assessed along with the therapeutic strategies opted by students. Results: Our study (n=186 demonstrated headache prevalence of 63.9% which was higher in females (74.3% as compared to males (32.6%. Headache experienced by majority of student population was bilateral (36.13%, sharp stabbing (38.65% and of moderate intensity (57.98%. Common associated symptoms were nausea/ vomiting (24.36% and scalp tenderness (22.68%. Stress (82.3% &irregular sleep (81.5% were the most common triggering factors. Prevalence of migraine was 13.44% with female preponderance (87.5%. Practice of self medication was reported by 88.2% of students. Most commonly used drugs were paracetamol (36.76%, aspirin (26.47% and combination of ibuprofen and paracetamol (25%. Specific medication use in migraineurs was found to be low (25% showing inadequate management of migraine headache in our study population. Conclusions: The results in this study demonstrate high headache prevalence in dental students with self medication being practiced by the majority. [Int J Basic Clin Pharmacol 2013; 2(1.000: 51-55

  20. Dental hygiene students' views on a service-learning residential aged care placement program.

    Science.gov (United States)

    Wallace, Janet P; Blinkhorn, Fiona A; Blinkhorn, Anthony S

    2014-10-01

    To record the views of final year dental hygiene students from the University of Newcastle, Australia about a placement in 17 residential aged care facilities, on the NSW Central Coast. Final year dental hygiene students undertook a 12 week placement, 1 day per week, in 1 of 17 residential aged care facilities. They were asked to participate in focus group discussions after the placement to determine their ability to transition from the classroom to the real-life experience of the residential aged care facility placement. Students felt ill-equipped for the aged care placement program even though they had attended a pre-placement orientation. Students expressed feelings of being overwhelmed by the residential aged care environment, particularly by the smells and unexpected sights of the aged, fragile and cognitively impaired residents, and the difficulties in providing them with oral hygiene care. To enable students to transition from the classroom to the aged care environment in a more effective manner, a more realistic pre-placement orientation program is necessary. Copyright © 2014 The American Dental Hygienists’ Association.

  1. Access to expert stroke care with telemedicine: REACH MUSC

    Directory of Open Access Journals (Sweden)

    Abby Swanson Kazley

    2012-03-01

    Full Text Available Stroke is a leading cause of death and disability, and rtPA can significantly reduce the long-term impact of acute ischemic stroke (AIS if given within 3 hours of symptom onset. South Carolina is located in the stroke belt and has a high rate of stroke and stroke mortality. Many small rural SC hospitals do not maintain the expertise needed to treat AIS patients with rtPA. MUSC is an academic medical center using REACH MUSC telemedicine to deliver stroke care to 15 hospitals in the state, increasing the likelihood of timely treatment with rtPA. The purpose of this study is to determine the increase in access to rtPA through the use of telemedicine for AIS in the general population and in specific segments of the population based on age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality.We used a retrospective cross-sectional design examining Census data from 2000 and Geographic Information Systems (GIS analysis to identify South Carolina residents that live within 30 or 60 minutes of a Primary Stroke Center (PSC or a REACH MUSC site. We include all South Carolina citizens in our analysis and specifically examine the population’s age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality. Our sample includes 4,012,012 South Carolinians. The main measure is access to expert stroke care at a Primary Stroke Center (PSC or a REACH MUSC hospital within 30 or 60 minutes. We find that without REACH MUSC, only 38% of the population has potential access to expert stroke care in SC within sixty minutes given that most PSCs will maintain expert stroke coverage. REACH MUSC allows 76% of the population to be within sixty minutes of expert stroke care, and 43% of the population to be within 30 minute drive time of expert stroke care. These increases in access are especially significant for groups that have faced disparities in care and high rates of AIS. The use of telemedicine can

  2. A survey of dental school's emergency departments in Ireland and the UK: provision of undergraduate teaching and emergency care

    OpenAIRE

    2015-01-01

    Aim Emergency dental care is a vital service that new graduates should be prepared to offer. There are few published data relating to emergency dental care education. To assess this, and to gain a profile of accident and emergency departments (A&E) in dental schools, an online survey was sent to all of the dental schools in the Republic of Ireland and the UK. Setting The survey addressed the school's A&E curriculum, teaching methods, undergraduate exposure and departmental details. Results Th...

  3. Modeling Dental Health Care Workers' Risk of Occupational Infection from Bloodborne Pathogens.

    Science.gov (United States)

    Capilouto, Eli; And Others

    1990-01-01

    The brief paper offers a model which permits quantification of the dental health care workers' risk of occupationally acquiring infection from bloodborne pathogens such as human immunodeficiency virus and hepatitis B virus. The model incorporates five parameters such as the probability that any individual patient is infected and number of patients…

  4. [The impact of frailty on the oral care behaviour and dental service use of elderly people

    NARCIS (Netherlands)

    Niesten, D.; Sanden, W.J.M. van der; Gerritsen, A.E.

    2015-01-01

    In order to explore how the level of frailty and various frailty factors affect the dental service use and oral self-care behaviour of frail elderly people, 51 frail elderly people were interviewed. Additional information on age, gender, living situation, prosthetic status, self-reported health and

  5. Dental Care Knowledge and Practice of a Group of Health Workers ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research | Sep-Oct 2014 | Vol 4 | Special Issue 3 |. 307. Address ... assess the knowledge and practice of health workers in a private medical health facility on dental care. ..... J Hosp Tourism. Educ 2011 ...

  6. Factors related to receipt of dental care in Eastern Iowa nursing facilities.

    Science.gov (United States)

    Ghazal, Tariq S; Caplan, Daniel J; Cowen, Howard J; Oliveira, Deise

    2015-01-01

    To assess factors related to nursing facility residents' receipt of dental treatment when it was offered on site. Screening forms that included demographic, general, and dental health information were obtained from residents of 10 nursing facilities in Eastern Iowa, and their dental procedure history for up to 7 years after screening was recorded. Residents were grouped as having received either no procedures; diagnostic procedures only; or nondiagnostic procedures. Of the 586 residents, the mean age was 83.8 years at screening and 31.3% were edentulous. The odds of receiving nondiagnostic procedures were lower among residents who were older (OR = 0.98, 95%CI 0.96-0.99) or edentulous (OR = 0.31, 95%CI 0.20-0.46), compared to those who received no dental procedures. Those who were older or edentulous had lower odds of receiving nondiagnostic dental procedures. Well-designed prospective cohort studies are needed to better evaluate barriers to receipt of dental treatment among the institutionalized elderly. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  7. Oral and dental health care practices in pregnant women in Australia: a postnatal survey

    Directory of Open Access Journals (Sweden)

    Middleton Philippa F

    2008-04-01

    Full Text Available Abstract Background The aims of this study were to assess women's knowledge and experiences of dental health in pregnancy and to examine the self-care practices of pregnant women in relation to their oral health. Methods Women in the postnatal ward at the Women's and Children's Hospital, Adelaide, completed a questionnaire to assess their knowledge, attitudes and practices to periodontal health. Pregnancy outcomes were collected from their medical records. Results were analysed by chi-square tests, using SAS. Results Of the 445 women enrolled in the survey, 388 (87 per cent completed the questionnaire. Most women demonstrated reasonable knowledge about dental health. There was a significant association between dental knowledge and practices with both education and socio-economic status. Women with less education and lower socio-economic status were more likely to be at higher risk of poor periodontal health compared with women with greater levels of education and higher socioeconomic status. Conclusion Most women were knowledgeable about oral and dental health. Lack of knowledge about oral and dental health was strongly linked to women with lower education achievements and lower socioeconomic backgrounds. Whether more intensive dental health education in pregnancy can lead to improved oral health and ultimately improved pregnancy outcomes requires further study.

  8. Receipt of preventive dental care among special-needs children enrolled in Medicaid: a crisis in need of attention.

    Science.gov (United States)

    Mitchell, Jean M; Gaskin, Darrell J

    2008-10-01

    Although not widely recognized, tooth decay is the most common childhood chronic disease among children ages five to seventeen. Despite higher rates of dental caries and greater needs, low-income minority children enrolled in Medicaid are more likely to go untreated relative to their higher income counterparts. No research has examined this issue for children with special needs. We analyzed Medicaid enrollment and claims data for special-needs children enrolled in the District of Columbia Medicaid program to evaluate receipt of recommended preventive dental care. Use of preventive dental care is abysmally low and has declined over time. Enrollment in managed care rather than fee for service improves the likelihood that special-needs children receive recommended preventive dental services, whereas residing farther from the Metro is an impediment to receipt of dental care.

  9. Dental Caries (Tooth Decay)

    Science.gov (United States)

    ... Find Data by Topic > Dental Caries (Tooth Decay) Dental Caries (Tooth Decay) Main Content Dental caries (tooth decay) remains the most prevalent chronic ... important source of information on oral health and dental care in the United States since the early ...

  10. [Waste management from dental care in the health districts of Dakar, Senegal].

    Science.gov (United States)

    Faye, D; Mbacké Lo, C M; Kanouté, A

    2014-01-01

    Management of medical waste is becoming an increasing public health concerns, especially as these waste treatment methods can themselves create both health and environmental risks. The objective of the study was to evaluate the management of waste from dental care in Dakar. A cross-sectional, descriptive study of dental services in Dakar, based on a questionnaire was used to determine the knowledge and attitudes of dentists on the management of dental waste. All practitioners stated that their offices had waste bins, 81.2% using plastic bags; 73.2% reported that the bins were washed and disinfected an average of once a day. Only 7.2% of the offices or facilities had an autoclave, and 5.8% an incinerator. Three quarters of the respondents did not know how to dispose of contaminated waste and none of them had conducted a study to estimate the quantity of their departmental waste. The management of waste from dental care is not structured in Senegal nor in most developing countries. Moreover, the gaps and ineffectiveness of legislation result in major threats to public health and the environment. The government should focus, among other things, on stakeholder awareness and training, by providing facilities with the resources necessary to contribute to sustainable development through the management of dental waste.

  11. Alaska Dental Health Aide Program

    Directory of Open Access Journals (Sweden)

    Sarah Shoffstall-Cone

    2013-08-01

    Full Text Available Background. In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska’s Tribal Health Organizations (THO developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  12. Caring for cancer patients in the general dental office

    Energy Technology Data Exchange (ETDEWEB)

    McDermott, I.

    Modern therapeutic modalities and emphasis on early detection have made oral cancer a treatable, and in many cases, a curable disease. The role of the dentist in cancer patient management is two-fold. Early detection of oral lesions during routine dental examination has been shown to be a significant factor in cancer diagnosis. The dentist's other role comes after cancer treatment, specifically therapeutic radiation. Ionizing radiation can have permanent effects on both hard and soft tissues. Prescription and use of fluoride gel in topical applicators can aid in assuring oral health for post-cancer patients.

  13. Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

    Science.gov (United States)

    Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

    2017-03-01

    To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  14. Children with Hemophilia and their Dental Care by Pediatric Stomatology. Review of Literature

    OpenAIRE

    Grandas Ramírez, Ángela Liliana; Universidad Nacional de Colombia. Bogotá, Colombia

    2016-01-01

    ABSTRACT. Purpose: To carry out systematic review of literature about diagnostics, severity, and dental treatment considerations of children with Hemophilia A. Methods: The search for articles and other document was conducted through the databases available at the National Library System of the National University of Colombia. The English and Spanish terms used in the search were “pediatric dentistry,” “hemophilia A,” dental care,” “coagulation factors,” and/or “coagulation disorders.” Result...

  15. Training pediatric health care providers in prevention of dental decay: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zeldin Leslie P

    2007-11-01

    Full Text Available Abstract Background Physicians report willingness to provide preventive dental care, but optimal methods for their training and support in such procedures are not known. This study aimed to evaluate the effect of three forms of continuing medical education (CME on provision of preventive dental services to Medicaid-enrolled children by medical personnel in primary care physician offices. Methods Practice-based, randomized controlled trial. Setting: 1,400 pediatric and family physician practices in North Carolina providing care to an estimated 240,000 Medicaid-eligible children aged 0–3 years. Interventions: Group A practices (n = 39 received didactic training and course materials in oral health screening, referral, counseling and application of fluoride varnish. Group B practices (n = 41 received the same as Group A and were offered weekly conference calls providing advice and support. Group C practices (n = 41 received the same as Group B and were offered in-office visit providing hands-on advice and support. In all groups, physicians were reimbursed $38–$43 per preventive dental visit. Outcome measures were computed from reimbursement claims submitted to NC Division of Medical Assistance. Primary outcome measure: rate of preventive dental services provision per 100 well-child visits. Secondary outcome measure: % of practices providing 20 or more preventive dental visits. Results 121 practices were randomized, and 107 provided data for analysis. Only one half of Group B and C practices took part in conference calls or in-office visits. Using intention-to-treat analysis, rates of preventive dental visits did not differ significantly among CME groups: GroupA = 9.4, GroupB = 12.9 and GroupC = 8.5 (P = 0.32. Twenty or more preventive dental visits were provided by 38–49% of practices in the three study groups (P = 0.64. Conclusion A relatively high proportion of medical practices appear capable of adopting these preventive dental services

  16. The routine utilization of dental care during pregnancy in eastern China and the key underlying factors: a Hangzhou City study.

    Directory of Open Access Journals (Sweden)

    Wei Sun

    Full Text Available OBJECTIVES: Oral diseases are associated with adverse pregnancy outcomes. The routine utilization of dental care (RUDC during pregnancy is an effective way to improve pregnant women's oral health, and thus safeguard the health of their babies. As China has one fifth of the world's population, it is especially meaningful to encourage RUDC there. However, the status of RUDC in China and the key underlying factors are largely unknown. METHODS: This cross-sectional survey investigated the current status of RUDC during pregnancy and the key underlying factors in Hangzhou City, Zhejiang Province, eastern China. We collected participants' demographics, individual oral-hygiene behaviors, individual lifestyle, oral-health conditions and attitudes, and also their RUDC during pregnancy. Binary Logistic Regression Analysis was used to analyze the key underlying factors. RESULTS: Only 16.70% of the participants reported RUDC during pregnancy. The percentage of RUDC was significantly lower among pregnant women with the following characteristics: aged 30 or less, an annual household income under $8,000, brushing once a day or less, never flossing or rinsing the mouth, paying no attention to pregnancy-related oral-health knowledge, and being dissatisfied with one's individual dental hygiene behavior. CONCLUSIONS: RUDC during pregnancy is very low in eastern China and is greatly influenced not only by a woman's age, annual income, individual hygiene behavior, but also by her attention and attitudes to oral health. To improve this population's access to and use of dental care during pregnancy, appropriate programs and policies are urgently needed.

  17. Fraser Syndrome-Oral Manifestations and a Dental Care Protocol

    Directory of Open Access Journals (Sweden)

    Talita Lopes de Oliveira

    2014-01-01

    Full Text Available Fraser syndrome is a rare genetic malformation with an autosomal recessive pattern of inheritance and an incidence of consanguinity ranging from 15% to 25%. A 5-year-old male patient who is a carrier of Fraser syndrome initiated treatment in the pediatric dentistry sector. The patient was fed parenterally since birth, experienced recurring bouts of chronic lung disease, and was referred to the pediatric dentistry sector by the medical team. Radiographic examination revealed the presence of all permanent teeth. Supragingival dental calculus, halitosis, and gingival inflammation were also observed. Dental calculus was removed by manual scraping, and chemotherapeutic agents were used, chlorhexidine 0,12%, chlorhexidine gel 2%, and PVP-I, to control the bacterial flora. The patient is still being monitored after an 8-year follow-up period, the complications associated with periodontal disease decreased, and since the initiation of treatment, the patient has not needed to be hospitalized because of chronic lung disease. This study reports the case of a patient diagnosed with Fraser syndrome and describes the clinical manifestations (general and oral.

  18. Need for accessible infertility care in Ghana: the patients’ voice

    Science.gov (United States)

    Osei, Nana Yaw

    2016-01-01

    Abstract According to the Ghana Statistical Service (GSS) infertility and childlessness are the most important reason for divorce in Ghana. The traditional Ghanaian society is pro-natal and voluntary childlessness is very uncommon. Patient groups are almost non-existent in Sub-Saharan Africa, aggravating the situation of childless couples. Due to the lack of enough and affordable high quality infertility services, many women resort to traditional healing, witchcraft and spiritual mediation. Considering the severe sociocultural and economic consequences of childlessness, especially for women, there is an urgent need for accessible and affordable high quality infertility care in Ghana. PMID:27909570

  19. Measuring access to emergency obstetric care in rural Zambia

    OpenAIRE

    Levine, Adam C.; Regan H Marsh; Nelson, Sara W.; Tyer-Viola, Lynda; Burke, Thomas F

    2008-01-01

    Background Global health experts identify emergency obstetric care (EmOC) as the most important intervention to improve maternal survival in low- and middle-income countries. In Zambia, 1 in 27 women will die of maternal causes, yet the level of availability of EmOC is not known at the provincial level. Aims Our goal was to develop a tool to measure the availability of EmOC in rural Zambia in order to estimate pregnant women?s access to this life-saving intervention. Methods We created an ins...

  20. Measuring access to emergency obstetric care in rural Zambia

    OpenAIRE

    Levine, Adam C; Marsh, Regan H.; Nelson, Sara W.; Tyer-Viola, Lynda; Burke, Thomas F.

    2008-01-01

    Background Global health experts identify emergency obstetric care (EmOC) as the most important intervention to improve maternal survival in low- and middle-income countries. In Zambia, 1 in 27 women will die of maternal causes, yet the level of availability of EmOC is not known at the provincial level. Aims Our goal was to develop a tool to measure the availability of EmOC in rural Zambia in order to estimate pregnant women’s access to this life-saving intervention. Methods We created an ins...

  1. [Ethics in pediatric emergencies: Care access, communication, and confidentiality].

    Science.gov (United States)

    Benoit, J; Berdah, L; Carlier-Gonod, A; Guillou, T; Kouche, C; Patte, M; Schneider, M; Talcone, S; Chappuy, H

    2015-05-01

    Children suffer most from today's increasing precariousness. In France, access to care is available for all children through various structures and existing measures. The support for foreign children is overseen by specific legislation often unfamiliar to caregivers. Pediatric emergencies, their location, organization, actors, and patient flow are a particular environment that is not always suitable to communication and may lead to situations of abuse. Communication should not be forgotten because of the urgency of the situation. The place of the child in the dialogue is often forgotten. Considering the triangular relationship, listening to the child and involving the parents in care are the basis for a good therapeutic alliance. Privacy and medical confidentiality in pediatric emergencies are governed by law. However, changes in treatments and medical practices along with the variety of actors involved imply both individual and collective limitations, to the detriment of medical confidentiality. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Streptococcus salivarius meningitis after dental care: case report

    Directory of Open Access Journals (Sweden)

    Maira Zoppelletto

    2012-12-01

    Full Text Available Introduction. Streptococcus salivarius is a common commensal of the oral mucosa, associated with infections in different sites. Meningitis due to this species are described in a few occasions . In this study refer to a case recently diagnosed in our hospital for treatment of a subsequent dental caries. Case report. A man of 35 years, presents to the emergency room with fever, headache, confusion, marked nuchal rigor.Anamnesis is the treatment of dental caries on the previous day.The blood count showed 24.7x109 / L with WBC 22.9x109 / L (92.9% neutrophils. The lumbar puncture CSF noted cloudy with 15.0 x 109 / L WBC, glicorrachia 5 g / L, protidorrachia 6.5 g / L. Microscopic examination showed numerous granulocytes and prevalence of Gram-positive cocci.The pneumococcal antigen was negative.The blood cultures before starting antibiotic therapy, were negative. CSF was isolated from the culture of a Streptococcus salivarius. To antibiotic therapy started in the ED, after lumbar puncture is associated with the Ampicillin Ceftriaxone and continued for 15 days to improve the patient’s general condition, then resigned in the 17 th day. Materials and methods. From CSF inoculated in blood agar plates and chocolate agar alpha hemolytic colonies were isolated, catalysis negative, optochin resistant. The biochemical identification performed with Phoenix (BD and confirmed by PCR Pan bacterial (16S rDNA bacterial strain identified as Streptococcus salivarius.The antibiogram performed with Phoenix (BD according to the CLSI guidelines indicated sensitivity to penicillin, vancomycin, cefotaxime, cefepime, and chloramphenicol. Conclusions. Meningitis by Streptococcus salivarius was found in a few cases, mainly related to the transmission of health personnel from the oral cavity during lumbar punctures performed without the use of surgical masks. The following bacterial meningitis in dental treatment having a low incidence and often fatal course be suspected by

  3. Efficacy of Video-Assisted Instruction on Knowledge and Performance of Dental Students in Access Cavity Preparation

    OpenAIRE

    Naseri, Mandana; Shantiaee, Yazdan; Rasekhi, Javid; Zadsirjan, Saeede; Mojtahed Bidabadi, Maryam; Khayat, Akbar

    2016-01-01

    Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the small size of the oral cavity, students cannot closely observe the clinical procedure. Use of new teaching modalities such as the intraoral camera may obviate this problem. This study assessed the effect of video-assisted clinical instruction in dentistry (VACID) on dental student’s knowledge and performance in access cavity preparation during endodontic treatment. Methods and Materials: In this inter...

  4. Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years.

    Science.gov (United States)

    Burgette, Jacqueline M; Preisser, John S; Weinberger, Morris; King, Rebecca S; Lee, Jessica Y; Rozier, R Gary

    2017-04-01

    To examine the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. We performed a quasi-experimental study in which we interviewed 479 EHS and 699 non-EHS parent-child dyads at baseline (2010-2012) and at a 24-month follow-up (2012-2014). We estimated the effects of EHS participation on the probability of having a dental care visit after controlling for baseline dental care need and use and a propensity score covariate; we included random effects to account for EHS program clustering. The odds of having a dental care visit of any type (adjusted odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.74, 3.48) and having a preventive dental visit (adjusted OR = 2.6; 95% CI = 1.84, 3.63) were higher among EHS children than among non-EHS children. In addition, the adjusted mean number of dental care visits among EHS children was 1.3 times (95% CI = 1.17, 1.55) the mean number among non-EHS children. This study is the first, to our knowledge, to demonstrate that EHS participation increases dental care use among disadvantaged young children.

  5. Dental Sealants

    Science.gov (United States)

    ... Dates Electronic Submission of Applications Grants 101 (How to Write a Grant) Questions and Answers Grant Writing Tips ... offers strategies for providing oral care. NIDCR > Data & Statistics > Find Data by Topic > Dental Sealants Dental Sealants ...

  6. [Do long-term care residents benefit from the dental bonus system?].

    Science.gov (United States)

    Nitschke, I; Bär, C; Hopfenmüller, W; Roggendorf, H; Stark, H; Sobotta, B; Reiber, Th

    2011-06-01

    Oral health of long-term care (LTC) residents is often poor. From 30 random German LTC facilities, 242 random residents (Berlin n=75, Northrhine-Westfalia (NRW) n=94, Saxony n=73) (median age: 82 years, female: 78.5%) were interviewed as to their use of dental services, possession of a bonus booklet (BB), and completeness of records. Only 18.6% possessed a BB. Significant regional differences were observed (Berlin=5.3%, NRW=18.1%, Saxony=32.9%) (χ(2) test p<0.01). The number of teeth was higher (Mann-Whitney test p=0.01) and the time since last dental visit shorter (p<0.01) for all residents with a BB. Only 18.6% of people possessing a BB declared not having had a dental appointment within the previous 12 months (LTC residents without BB 51.3%). As a means towards improved quality management in nursing, better oral infection control of residents and increased oral health and general quality of life, the introduction of a regular annual preventive dental screening program including the use of a dental bonus system are suggested.

  7. Evidence Based Dental Care: Integrating Clinical Expertise with Systematic Research

    OpenAIRE

    2014-01-01

    Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the “gold standard” in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21st century, more and more p...

  8. Methodology of the Access to Care and Timing Simulation Model for Traumatic Spinal Cord Injury Care.

    Science.gov (United States)

    Santos, Argelio; Fallah, Nader; Lewis, Rachel; Dvorak, Marcel F; Fehlings, Michael G; Burns, Anthony Scott; Noonan, Vanessa K; Cheng, Christiana L; Chan, Elaine; Singh, Anoushka; Belanger, Lise M; Atkins, Derek

    2017-03-12

    Despite the relatively low incidence, the management and care of persons with traumatic spinal cord injury (tSCI) can be resource intensive and complex, spanning multiple phases of care and disciplines. Using a simulation model built with a system level view of the healthcare system allows for prediction of the impact of interventions on patient and system outcomes from injury through to community reintegration after tSCI. The Access to Care and Timing (ACT) project developed a simulation model for tSCI care using techniques from operations research and its development has been described previously. The objective of this article is to briefly describe the methodology and the application of the ACT Model as it was used in several of the articles in this focus issue. The approaches employed in this model provide a framework to look into the complexity of interactions both within and among the different SCI programs, sites and phases of care.

  9. Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013✩

    Science.gov (United States)

    Thurman, David J.; Kobau, Rosemarie; Luo, Yao-Hua; Helmers, Sandra L.; Zack, Matthew M.

    2017-01-01

    Introduction Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care. Materials and methods We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity. Results Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR = 3.58) and less likely to have private health insurance (RR = 0.58). Adults with active epilepsy were also less likely to be employed (RR = 0.53) and much more likely to report being disabled (RR = 6.14). They experience greater barriers to health-care access including an inability to afford medication (RR = 2.40), mental health care (RR = 3.23), eyeglasses (RR = 2.36), or dental care (RR = 1.98) and are more likely to report transportation as a barrier to health care (RR = 5.28). Conclusions These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention. PMID:26627980

  10. MEDICO-SOCIAL CHARACTERISTICS OF POPULATION GROUPS SEEKING FOR DENTAL CARE IN POLYCLINICS SMOLENSK

    Directory of Open Access Journals (Sweden)

    Светлана Николаевна Дехнич

    2013-09-01

    Full Text Available The research’s aim is to give health-social characteristic of contingents of the urban population, seeking for outpatient dental care, including a comparative estimation of stomatological index of life quality (SILQ by doctors and patients.Novelty: Was installed the difference in the estimation of work sets SILQ by doctors and patients.Methodology of the research work. It was used an advantage «Card of studying the dental health» for holding the research, including the objective and subjective expert estimations of the dental patient’s status by doctors. This information was comparing with the subjective estimation of SILQ by patients. The sample volume was about 400 people out of number of people, seeking for outpatient dental care in state budget dental clinics during 2011-2012 years.Results. Was installed mostly very high level of prevalence of caries, the destruction of fabrics of parodont reaches 100 % with the age. The stomatological index of life quality among the patients, seeking for outpatient care is low. One of the reasons- a low population’s sanitary culture. A big part of patients seek in case of acute pain(40%. Out of three components of SILQ the criteria of social welfare got rather high estimation. The lowest estimation was given to moral psychological well-being criteria. In this case the moral psychological well-being criteria was given a higher estimation by doctors then by patients (in 1,8. The criteria of the physical and social well-being is lower compared with the patient’s (in 1,8 and 1,2 times respectively.Practical implication: Indicators SILQ may be the basis for planning activities of stomatological polyclinics, including the preventive dentists’ work.DOI: http://dx.doi.org/10.12731/2218-7405-2013-6-46

  11. American Dental Hygienists' Association

    Science.gov (United States)

    ... Resources Student Resources National Exam Student Advisor Resources Dental Hygiene Programs Scholarships and Grants Research Center Transforming Dental Hygiene Education Advocacy Practice Issues Direct Access Scope ...

  12. Periodontal status and dental care in HIV seropositive patients

    Directory of Open Access Journals (Sweden)

    Maria Sueli Marques Soares

    2009-12-01

    Full Text Available Objective: The aim of the study was to evaluate the correlation between CD4+ cell count and viral load with periodontal and dental status in HIV seropositive patient. Methods: Forty HIV seropositive patients were selected from the dental clinic of the Clementino Fraga Hospital in João Pessoa, Paraíba, Brazil. The Community Periodontal Index, Simplified Oral Hygiene Index and Decayed, Missing or Filled Teeth Index were determined. The values of CD4+ lymphocyte count and viral load were collected from the medical records. Descriptive analysis was made and Spearman’s correlation test was applied, with values of p<0.05 being significant. Results: HIV seropositive patients were aged 33 to 47 years (mean = 40 years, 26 were men and 14 women. The mean CD4+ lymphocyte count was 507.82±306.4 cells/mm3, with 41% being a high, 38.5% a medium and 20.5% a low level. Sixty-five percent of the patients had undetectable viral load, 12.5% had a high, 5% a low and 5% a medium viral load. Most patients (87.5% presented with periodontal disease, calculus was the most frequent condition (40%. The mean Decayed, Missing or Filled Tooth Index was 19.7±6.8, with prevalence of the missing component. There was significant statistical correlation between the CD4+ count and the periodontal condition, p=0.046. There was no significant correlation between the CD4+ count and the Decayed, Missing or Filled Teeth Index (p=0.469 and the Simplified Oral Hygiene Index (p=0.189 indexes, and between viral load and Decayed, Missing or Filled Teeth Index (p=0.452, the Simplified Oral Hygiene Index (p=0.158 and Community Periodontal Index (p=0.216. Conclusion: The periodontal condition was influenced to a greater by the CD4+ cell count than the viral load, while there was no correlation between the decayed condition and the CD4+ cell count or the viral load condition.

  13. Patients' choice of payment system in the Swedish Public Dental Service--views on dental care and oral health.

    Science.gov (United States)

    Ostberg, Anna-Lena; Ahlström, Birgitta; Hakeberg, Magnus

    2013-01-01

    The aim of this study was to generate new knowledge of considerations and factors having impacted the patients' choice of payment system and their views on oral health. Moreover, their later attitudes to the prepaid risk-related payment system, having been enrolled or not, were explored. A qualitative design was chosen and data was collected through semi-structured interviews.Twenty patients in the Public Dental Service (PDS) in western Sweden were strategically sampled with reference to gender, age (older/younger adults), residence (rural/urban), and choice of payment system:fee-for-service or capitation plan.The interview guide covered areas concerning the payment systems, patient considerations before choosing system, views of their own oral health and experiences of received dental care within the chosen system.The analysis was performed according to basic principles of qualitative content analysis. The results revealed two themes expressing the latent content. In the theme "The individual's relation to the PDS", expectations of the care, feelings of safety and aspects of responsibility emerged.The theme"Health-related attitudes and perceptions" revealed that views on health and self-assessment of oral health influenced the patients' considerations. Moreover, the perceived influence on oral health and risk thinking emerged as important factors in this theme. The conclusion was that the individual's relation to the PDS together with his/her health-related attitudes and perceptions were the main factors impacting the choice of payment system in the PDS. A health promotion perspective should be applied, empowering the patients to develop their risk awareness and their own resources.

  14. Evaluating quality of dental care among patients with diabetes: Adaptation and testing of a dental quality measure in electronic health records.

    Science.gov (United States)

    Neumann, Ana; Kalenderian, Elsbeth; Ramoni, Rachel; Yansane, Alfa; Tokede, Bunmi; Etolue, Jini; Vaderhobli, Ram; Simmons, Kristen; Even, Joshua; Mullins, Joanna; Kumar, Shwetha; Bangar, Suhasini; Kookal, Krishna; White, Joel; Walji, Muhammad

    2017-09-01

    Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)-based dental quality measure to determine whether patients with diabetes received such evaluations. The authors selected a Dental Quality Alliance measure developed for claims data and adapted the specifications for EHRs. Automated queries identified patients with diabetes across 4 dental institutions, and the authors manually reviewed a subsample of charts to evaluate query performance. After assessing the initial EHR measure, the authors defined and tested a revised EHR measure to capture better the oral care received by patients with diabetes. In the initial and revised measures, the authors used EHR automated queries to identify 12,960 and 13,221 patients with diabetes, respectively, in the reporting year. Variations in the measure scores across sites were greater with the initial measure (range, 36.4-71.3%) than with the revised measure (range, 78.8-88.1%). The automated query performed well (93% or higher) for sensitivity, specificity, and positive and negative predictive values for both measures. The results suggest that an automated EHR-based query can be used successfully to measure the quality of oral health care delivered to patients with diabetes. The authors also found that using the rich data available in EHRs may help estimate the quality of care better than can relying on claims data. Detailed clinical patient-level data in dental EHRs may be useful to dentists in evaluating the quality of dental care provided to patients with diabetes. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  15. User evaluation on dental care in the Unified Health System: an approach from the standpoint of humanization

    National Research Council Canada - National Science Library

    Suzely Adas Saliba Moimaz; Arinilson Moreira Chaves Lima; Clea Adas Saliba Garbin; Jose Eduardo Corrente; Nemre Adas Saliba

    2016-01-01

      The scope of this study was to assess user evaluation about dental care in the Unied Health System and analyze the associations between this evaluation, sociodemographic characteristics, and aspects...

  16. Evaluation of children′s behavior aged 0-3 years during dental care: A longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Ana Carolina SF

    2009-09-01

    Full Text Available Child temperament has been studied in various researches and may be useful to predict how a child responds to dental treatment, especially very young children. The purpose of the present longitudinal study was to evaluate the behavioral manifestation of children aged 0 to 3 years, considering different types of dental situation. A total of 169 children were selected and the following data were collected: the age of the child, gender, age of the mother, number of dental visits and their respective dates, stimuli offered to the child, and behavioral response to these stimuli. The children and their respective behaviors were divided into five groups according to the dental situation offered: control, missed visits, fluoride varnish, restoration, and dental trauma. The data were submitted to descriptive and inferential analysis using the chi-square test, with the level of significance set at 5%. Analysis of the different situation offered to infants during routine dental care revealed a predominance of collaborating and partially collaborating behavior, and age at the time of dental care influenced the behavior of the infants, irrespective of the stimulus group. The different types of dental situation provoked changes in the behavioral response of the children of certain age groups, especially in the dental trauma group.

  17. Spatial analysis of elderly access to primary care services

    Directory of Open Access Journals (Sweden)

    Lozano-Gracia Nancy

    2006-05-01

    Full Text Available Abstract Background Admissions for Ambulatory Care Sensitive Conditions (ACSCs are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. Conclusion The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across

  18. Influence of private practice employment of dental therapists in Saskatchewan on the future supply of dental therapists in Canada.

    Science.gov (United States)

    Uswak, Gerry; Keller-Kurysh, Emory

    2012-08-01

    The profession of dental therapy has long been held up as a model for reducing access to care barriers in high-risk, underserved populations worldwide. Dental therapists practice in many countries delivering preventive and basic restorative care to children and adults. In North America, dental therapy education and practice date back to 1972 with the establishment of training programs at the National School of Dental Therapy in Fort Smith, Northwest Territories, and the Wascana Institute of Applied Arts and Science in Regina, Saskatchewan, as a means of reducing access to care barriers in Canada's northern territories and to implement the Saskatchewan Health Dental Plan, respectively. At present, dental therapy in North America has reached a crossroads: in the United States, the profession is cautiously being explored as a solution for improving access to care in at-risk populations. In 2011, Canada's sole training program, the National School of Dental Therapy in Prince Albert, Saskatchewan, closed when the federal government eliminated its funding. This article examines the impact of private practice employment of dental therapists in Saskatchewan on the supply of dental therapist human resources for health in Canada's three northern territories (Northwest Territories, Nunavut, and Yukon), its role in the closure of the National School of Dental Therapy in 2011, and ramifications for the future of dental therapy in Canada.

  19. The Case for Improved Interprofessional Care: Fatal Analgesic Overdose Secondary to Acute Dental Pain during Pregnancy

    Science.gov (United States)

    Chuang, Alice; Munz, Stephanie M.; Dabiri, Darya

    2016-01-01

    Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure. In managing the pregnant patient, healthcare providers, including physicians and dentists, must recognize and optimize the interconnected relationships shared by the health disciplines. An interdisciplinary approach of collaborative and coordinated care, the timing, sequence, and treatment for the pregnant patient can be improved and thereby maximize overall quality of health. Continued efforts toward integrating oral health into general healthcare education through interprofessional education and practice are necessary to enhance the quality of care that will benefit all patients. PMID:27847654

  20. The Case for Improved Interprofessional Care: Fatal Analgesic Overdose Secondary to Acute Dental Pain during Pregnancy

    Directory of Open Access Journals (Sweden)

    Sarah K. Y. Lee

    2016-01-01

    Full Text Available Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure. In managing the pregnant patient, healthcare providers, including physicians and dentists, must recognize and optimize the interconnected relationships shared by the health disciplines. An interdisciplinary approach of collaborative and coordinated care, the timing, sequence, and treatment for the pregnant patient can be improved and thereby maximize overall quality of health. Continued efforts toward integrating oral health into general healthcare education through interprofessional education and practice are necessary to enhance the quality of care that will benefit all patients.

  1. Provision of dental care for special care patients: the view of Irish dentists in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Smith, G

    2010-04-01

    Part 2 of the Disability Act 2005 requires that all people with a disability are entitled to a needs assessment and, by implication, provision of identified care needs. This process started with children aged 0-6 in 2007 and will roll out to all people with disabilities by 2011. Oral health is part of that needs assessment but it may be that dentists are not in a position to provide that care, by virtue of a lack of education, training or facilities. The majority of dental care delivered would seem, from information gathered as part of this study, to be of an emergency nature. This study aimed to identify the shortfalls in service provision, and their potential causes, to inform what it is hoped will be a positive directive on special care dentistry (SCD) in the proposed National Oral Health Strategy.

  2. Provision of dental care for special care patients: the view of Irish dentists in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Smith, G

    2010-04-01

    Part 2 of the Disability Act 2005 requires that all people with a disability are entitled to a needs assessment and, by implication, provision of identified care needs. This process started with children aged 0-6 in 2007 and will roll out to all people with disabilities by 2011. Oral health is part of that needs assessment but it may be that dentists are not in a position to provide that care, by virtue of a lack of education, training or facilities. The majority of dental care delivered would seem, from information gathered as part of this study, to be of an emergency nature. This study aimed to identify the shortfalls in service provision, and their potential causes, to inform what it is hoped will be a positive directive on special care dentistry (SCD) in the proposed National Oral Health Strategy.

  3. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

    Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.

  4. Variation, Certainty, Evidence, and Change in Dental Education: Employing Evidence-based Dentistry in Dental Education.

    Science.gov (United States)

    Marinho, Valeria Coelho Catao; Richards, Derek; Niederman, Richard

    2001-01-01

    Using a case-based dental scenario, presents systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. Also discusses barriers inhibiting these systematic approaches to evidence-based…

  5. [Influence of the organization of primary care and the socio-demographic characteristics of the population on the demand for municipal emergency dental care].

    Science.gov (United States)

    da Fonseca, Dirce Aparecida Valerio; Mialhe, Fabio Luiz; Ambrosano, Glaucia Maria Bovi; Pereira, Antonio Carlos; Meneghim, Marcelo de Castro

    2014-01-01

    The scope of this study was to evaluate the influence of the social determinants and the provision of primary care services in relation to the use of emergency dental care services in a medium-sized municipality. Data recorded for the 57,231 users of emergency care between 2007 and 2009, in accordance with age, gender, date and period of dental care, social exclusion indices of the suburb in which they live and the existence of a benchmark oral health team, were used to perform the analysis. Of the total population, 5.24% on average per year used the service during the period under scrutiny, with the 20-49 year age group (63.84%) showing the highest demand and equality between genders for such care. Surgical procedures (54.90%) were the most prevalent with an increasing trend for restorative procedures (62,8%). Users living in areas of greater social exclusion were 4.15 times more likely to seek dental care (p gender or the existence of an oral health team of the suburb in which they live and the demand for emergency dental care. In conclusion, there was greater recourse to emergency municipal dental care by individuals living in vulnerable areas, proving the importance of such care in diminishing oral health inequality.

  6. General dental practitioners' opinions on orthodontics in primary and secondary care.

    Science.gov (United States)

    McMichael, J A

    1997-01-01

    A survey of 232 general dental practitioners was undertaken by the purchasing authorities in Hereford and Worcester, England, in 1993, to establish local practitioners' views on primary and secondary care orthodontics. The response rate was 90.1%. The dentists overestimated their orthodontic case-load: 66.6% of contract holders submitted no claims for upper removable appliances (URA) treatment, but 70.8% claimed they undertook removable appliance therapy. Dentists believed orthodontics should be a feature of the General Dental Services (GDS) but did not seem inclined to commit themselves to providing it. A majority of GDPs (54.9%) felt orthodontics was uneconomic under the GDS. There was support for the treatment planning role of hospitals, but although this was available locally it did not appear to have stimulated primary care provision. Consultant outreach clinics were not generally supported but there was a desire for more opportunities for hospital clinical attachments in orthodontics. The implications for the policies of National Health Service (NHS) purchasers are considered: purchasing health authorities need to carry out systematic assessment of the views of their general dental practitioners and take account of their desired patterns of specialist provision. Policies encouraging the shift of orthodontics into primary care are called into question by this study. If demand for orthodontics is to be met, policy should concentrate on the development of hospital services and specialist practitioners.

  7. Measuring access to emergency obstetric care in rural Zambia.

    Science.gov (United States)

    Levine, Adam C; Marsh, Regan H; Nelson, Sara W; Tyer-Viola, Lynda; Burke, Thomas F

    2008-06-01

    Global health experts identify emergency obstetric care (EmOC) as the most important intervention to improve maternal survival in low- and middle-income countries. In Zambia, 1 in 27 women will die of maternal causes, yet the level of availability of EmOC is not known at the provincial level. Our goal was to develop a tool to measure the availability of EmOC in rural Zambia in order to estimate pregnant women's access to this life-saving intervention. We created an instrument for determining the availability of EmOC based on the supplies and medicines in stock at health facilities as well as the skill level of health workers. We then surveyed a random sample of 35 health centres in the Central Province of Zambia using our novel instrument. We graded health centres based on their ability to provide the six basic functions of EmOC: administering parenteral antibiotics, administering parenteral oxytocics, administering parenteral anticonvulsants, performing manual removal of the placenta, removing retained products of conception and performing assisted vaginal delivery. Of the 29 health centres providing delivery care, 65% (19) were graded as level 1 or 2, 28% (8) as level 3 or 4 and 7% (2) as level 5. No health centre received a grade of level 6. The availability of EmOC in the Central Province of Zambia is extremely limited; the majority of health centres provide only one or two basic functions of EmOC, and no health centres perform all six functions. Our grading system allows for inter- and intra-country comparisons by providing a systematic process for monitoring access to EmOC in rural, low-income countries similar to Zambia.

  8. Defining Remoteness from Health Care: Integrated Research on Accessing Emergency Maternal Care in Indonesia

    Directory of Open Access Journals (Sweden)

    Bronwyn A Myers

    2015-07-01

    Full Text Available The causes of maternal death are well known, and are largely preventable if skilled health care is received promptly. Complex interactions between geographic and socio-cultural factors affect access to, and remoteness from, health care but research on this topic rarely integrates spatial and social sciences. In this study, modeling of travel time was integrated with social science research to refine our understanding of remoteness from health care. Travel time to health facilities offering emergency obstetric care (EmOC and population distribution were modelled for a district in eastern Indonesia. As an index of remoteness, the proportion of the population more than two hours estimated travel time from EmOC was calculated. For the best case scenario (transport by ambulance in the dry season, modelling estimated more than 10,000 fertile aged women were more than two hours from EmOC. Maternal mortality ratios were positively correlated with the remoteness index, however there was considerable variation around this relationship. In a companion study, ethnographic research in a subdistrict with relatively good access to health care and high maternal mortality identified factors influencing access to EmOC, including some that had not been incorporated into the travel time model. Ethnographic research provided information about actual travel involved in requesting and reaching EmOC. Modeled travel time could be improved by incorporating time to deliver request for care. Further integration of social and spatial methods and the development of more dynamic travel time models are needed to develop programs and policies to address these multiple factors to improve maternal health outcomes.

  9. Depression and suicide ideation among students accessing campus health care.

    Science.gov (United States)

    Mackenzie, Sara; Wiegel, Jennifer R; Mundt, Marlon; Brown, David; Saewyc, Elizabeth; Heiligenstein, Eric; Harahan, Brian; Fleming, Michael

    2011-01-01

    Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. "Days of exercise per week" was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.

  10. Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

    Directory of Open Access Journals (Sweden)

    Alba Sandra

    2007-06-01

    Full Text Available Abstract Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

  11. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    2007-01-01

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres (46

  12. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    2007-01-01

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres (46

  13. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres

  14. Antenatal Health Care and Postnatal Dental Check-Ups Prevent Early Childhood Caries.

    Science.gov (United States)

    Nakai, Yukie; Mori, Yukako; Tamaoka, Izumi

    2016-01-01

    The first stage of early childhood caries (ECC) is infection by mutans streptococci, of which the primary infection source is the child's mother. Early intervention programs including antenatal and postnatal phases are effective for reducing ECC. This study was conducted to assess the respective effects of antenatal health care and postnatal care such as regular dental check-ups on reducing ECC among 3-year-old Japanese children. This nested case-control study of 155 three-year-old children (49.0% boys) was conducted at a dental clinic that provides collaborative health services with the Obstetrics and Gynecology Clinic, Okayama. Child characteristics and the mothers' antenatal data were collected retrospectively from the dental charts. They were divided into two groups: caries-free children (n = 77) and children without ECC (n = 78). Most of the children (81.9%) received regular check-ups with topical fluoride application. Most of the mothers reported morning sickness during pregnancy (81.3%), normal delivery (72.9%), and used antenatal health care (80.6%). Over half (55.5%) were primigravida. Adjusted odds ratio (AOR) and 95% confidential interval (95% CI) were computed to assess the strength of association using logistic regression analysis. Receiving antenatal health care (AOR, 3.27; 95% CI, 1.30-8.24) and child's having regular check-ups (AOR, 3.42; 95% CI, 1.35-8.69) were significantly associated with caries-free status among three-year old children. For ECC prevention, antenatal health care is as effective as regular check-ups up to three years of age. The results of this retrospective study demonstrate that maternal health education during pregnancy is effective for ECC prevention.

  15. Access to health care: solidarity and justice or egoism and injustice?

    Science.gov (United States)

    Prudil, Lukas

    2008-09-01

    The aim of this paper is to answer the question whether there is a real demand for equal access to health care or--better--to medical care and which interest groups (patients, health care professionals, policy makers and others) are interested in equal access. The focus is on EU countries including recent case law from the European Court of Justice and the European Court of Human Rights. We discuss whether there is a need to have legislative safeguards to protect equal access to medical care and whether such norms really work. The paper concludes that some of the key players in medical care are not primarily governed by a real willingness to have equal and just access to medical care, but by rather egoistic approaches. It seems that policy makers and politicians are the only ones who, surprisingly, must at least formally call for and enforce equal access to medical care. Interests of other groups seem to be different.

  16. Pittsburgh as a High Risk Population: The Potential Savings of a Personalized Dental Care Plan

    Science.gov (United States)

    Ng, Andrew J.

    2016-01-01

    Objectives. Little evidence exists for the current standard of two annual preventative care visits. The purpose of this study was investigate this claim by modeling the potential savings of implementing a personalized care plan for high risk individuals in the Pittsburgh region. Methods. Using radiographs from 39 patients in the University of Pittsburgh Dental Registry and DNA Repository database, two models were created to analyse the direct savings of implementing a more aggressive preventative treatment plan and to view the longitudinal cost of increased annual yearly visits. Results. There is a significant decrease (p < 0.001) between original and modeled treatment cost when treatment severity is reduced. In addition, there is a significant decrease in adult lifetime treatment cost (p < 0.001) for up to four annual visits. Conclusions. Patients in high risk populations may see significant cost benefits in treatment cost when a personalized care plan, or higher annual preventative care visits, is implemented. PMID:27006657

  17. Pittsburgh as a High Risk Population: The Potential Savings of a Personalized Dental Care Plan

    Directory of Open Access Journals (Sweden)

    Andrew J. Ng

    2016-01-01

    Full Text Available Objectives. Little evidence exists for the current standard of two annual preventative care visits. The purpose of this study was investigate this claim by modeling the potential savings of implementing a personalized care plan for high risk individuals in the Pittsburgh region. Methods. Using radiographs from 39 patients in the University of Pittsburgh Dental Registry and DNA Repository database, two models were created to analyse the direct savings of implementing a more aggressive preventative treatment plan and to view the longitudinal cost of increased annual yearly visits. Results. There is a significant decrease (p<0.001 between original and modeled treatment cost when treatment severity is reduced. In addition, there is a significant decrease in adult lifetime treatment cost (p<0.001 for up to four annual visits. Conclusions. Patients in high risk populations may see significant cost benefits in treatment cost when a personalized care plan, or higher annual preventative care visits, is implemented.

  18. Task-role-based Access Control Model in Smart Health-care System

    Directory of Open Access Journals (Sweden)

    Wang Peng

    2015-01-01

    Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

  19. Oral health services in primary care nursing centers: opportunities for dental hygiene and nursing collaboration.

    Science.gov (United States)

    Fellona, M O; DeVore, L R

    1999-01-01

    The basic oral health needs of more than 100 million Americans are not being met, which places them at an increased risk for serious oral and systemic health consequences. Primary care nursing centers, a comparatively new method of health care delivery, provide health care screening, education, and referral services to person typically underserved in the traditional health care delivery system. Primary care nursing centers were surveyed to determine to what extent they provide oral health screening, education, and referral services for clients, and to identify factors that discourage and encourage the integration of these services. Nurses from 158 primary care nursing centers in the United States made up the study population. Data were collected using a self-administered questionnaire. Data from 59 primary care nursing centers were analyzed using frequency distributions and measures of central tendency. Almost half of the responding nurses at primary care nursing centers "almost always" screen their clients for gum infections (49%) and oral lesions (48%). Fewer teach their clients how to perform oral cancer self-examinations (20%); or educate them regarding use of athletic mouth protectors (15%), the effects of xerostomia (19%), and the benefits of fluoride (38%). The majority do not always refer clients needing treatment for dental decay (55%), gum infections (61%), missing teeth (80%), oral lesions (67%), oral pain (64%), or oral trauma (65%). Lack of referral sources (64%) and unavailability of oral health professionals to provide on site basic oral health services (63%) were the leading factors that discourage the integration of oral health services in the centers. An appreciation for the benefits of oral health (73%) and a knowledgeable clinician to perform oral health services (68%) were the leading factors that encourage the integration of oral health services into primary care nursing centers. These data could be useful in planning, implementing, and

  20. Attitudes of Korean Dental Students Toward Individuals with Special Health Care Needs.

    Science.gov (United States)

    Lee, Hyo-Seol; Jung, Hoi In; Kim, Seon-Mi; Kim, Jiyoen; Doh, Re Mee; Lee, Jae-Ho

    2015-09-01

    The purposes of this study were to ascertain the attitudes of dental students toward individuals with special health care needs (SHCNs) in Korea and to elucidate the characteristics associated with these attitudes. The authors recruited students from four of the 11 dental schools in Korea to participate in a survey; these schools were selected for regional balance. The Scale of Attitudes toward Disabled Persons (SADP) was used as the primary survey instrument, and ten independent variables were included. Of the 1,100 possible participants, 1,057 responded to the survey, for a response rate of 96.1%. The results showed that although the students' attitudes did not differ significantly by gender, their attitudes did show statistically significant differences on nine other variables: age, year, religion, self-esteem, friends with a disability, volunteering, admission course, concern for individuals with SHCNs, and intention to treat individuals with SHCNs (all p<0.05). The attitudes of these Korean dental students toward individuals with SHCNs were relatively unfavorable, showing lower SADP scores than reported in Western countries and likely reflecting Eastern cultural values in general. Future efforts should place greater emphasis on special care dentistry education and encourage the development of more favorable attitudes regarding the treatment of individuals with SHCNs.

  1. Facilitating organizational mergers: amalgamation of community care access centres.

    Science.gov (United States)

    Mercer, Kevin

    2008-01-01

    The development of 14 Local Health Integration Networks (LHINs) in Ontario necessitated the re-organization of Community Care Access Centres (CCACs). The achievement of LHIN objectives was contingent upon the organizations responsible for home and long-term care placement being aligned within the LHIN geographic boundaries. This re-alignment required 42 provincial organizations to re-structure, integrate and reduce to 14. This project was focused on the amalgamation of two CCACs in the Waterloo Wellington LHIN. Both were distinctly different due to their organizational evolution, the composition of the region and leadership approach. The different organizational cultures, if not managed properly, could result in a derailing of several current projects that were underway and were also key to the overall health system transformation agenda. A literature search provided a plethora of critiques of organizational change approaches and practical suggestions. Of particular relevance was a report to the Royal Commission on Health Care in 2002 that authenticates the dismal success in health care to meet change objectives. The project included a joint planning day for the leadership teams of the two organizations followed by an Organizational Readiness Assessment conducted by the Canadian Council on Health Services Accreditation (CCHSA). Both activities brought the leadership and staff of Waterloo and Wellington together, started the integration process and solicited staff participation. A follow-up survey of the leadership teams revealed the effectiveness of the project in advancing integration between the two organizations and recognizing organizational cultural differences. The CCHSA Organizational Readiness Assessment process was viewed as an effective means for advancing the integration of the two organizations, particularly as it relates to allowing the staff groups to define for themselves the benefits of the merger. The lack of hard evidence on the benefits of a

  2. Unregulated access to health-care services is associated with overutilization--lessons from Austria.

    Science.gov (United States)

    Pichlhöfer, Otto; Maier, Manfred

    2015-06-01

    The Austrian health-care system is characterized by free provider choice and uncontrolled access to all levels of care. Using primary data, the ECOHCARE study shows that hospitalization rates for the secondary and tertiary care levels in Austria are both 4.4 times higher than those reported from the USA using a similar methodology. At the same time, essential functions of the primary care sector are weak. We propose that regulating access to secondary and tertiary care and restricting free provider choice to the primary care level would both reverse over utilization and strengthen the primary care sector.

  3. AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

    Directory of Open Access Journals (Sweden)

    Ebener Steeve

    2008-12-01

    Full Text Available Abstract Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1 modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2 modeling geographic coverage according to the availability of services; (3 projecting the coverage of a scaling-up of an existing network; (4 providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on

  4. The Effect of Dental Insurance on the Use of Dental Care For Older Adults: A Partial Identification Analysis*

    Science.gov (United States)

    Kreider, Brent; Moeller, John; Manski, Richard J.; Pepper, John

    2014-01-01

    We evaluate the impact of dental insurance on the use of dental services using a potential outcomes identification framework designed to handle uncertainty created by unknown counterfactuals – that is, the endogenous selection problem – as well as uncertainty about the reliability of self-reported insurance status. Using data from the Health and Retirement Study, we estimate that utilization rates of adults older than 50 would increase from 75% to around 80% under universal dental coverage. PMID:24890257

  5. Perceptions of autistic children’s parents about dental care: Preliminary study. Concepción, 2012.

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2014-09-01

    Full Text Available The aim of this study was to describe the perceptions of parents of children with autistic disorder (AD of the school of Association of Parents and Friends of Autistics (ASPAUT Chiguayante. A cross-sectional and exploratory study was conducted. The target population were the parents of 60 schoolchildren at ASPAUT school. The measuring instrument was a survey of thirty closed questions and one open question. Of the 60 surveys sent out 26 were recovered with varying degrees of response to each of the questions. Almost all children with AD receives dental care, about 1 time per year and mostly by pediatric dentists. There is generally a good perception of the care provided, but the need for specialized in autism spectrum disorders professionals, the existence of specific dental programs and reducing the associated costs are recognized. The issues identified by parents as most relevant for improving care were: a specialized dental care (26.9%, more humane treatment (19.2% and using distracting techniques (11.5%. 15.4% of parents believe good dental care as well as excellent. In Chile the dental care of this population is just beginning and there are many areas that need improvements.

  6. Acceptable care? Illness constructions, healthworlds, and accessible chronic treatment in South Africa.

    Science.gov (United States)

    Fried, Jana; Harris, Bronwyn; Eyles, John; Moshabela, Mosa

    2015-05-01

    Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas-conversely-these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating "disease" to responding to "illness" by acknowledging and incorporating patients' healthworlds in patient-provider interactions. © The Author(s) 2015.

  7. Peran komunikasi interpersonal dalam pelayanan kesehatan gigi (The role of interpersonal communication integrated with medical dental care

    Directory of Open Access Journals (Sweden)

    Hanindio Soelarso

    2005-09-01

    Full Text Available This article is a literature study, concerning the interpersonal communication role in conjunction with technical dental and oral health care conducted by the dentists towards the patient individually. In addition, interpersonal communication means to be synergic communication among dentist and the patient. In relation with the verbal or non verbal dental care process, the effectiveness of interpersonal communication is identified through the perception of the messages and it’s translated by recipient perception, and it will be the same meaning as the messager’s perception. In this case, the dentist and the patient will be capable to send or accept mutual messages as messanger and message recipient. In conclusion, in the dental and oral medical care on the procedure point of view, the similar perception determines very much the successfulness of the wholedental and oral health care process toward diagnosis, determination therapy plan, treatment and post treatment process.

  8. Dental Provider Attitudes Are a Barrier to Expanded Oral Health Care for Children ≤3 Years of Age

    Directory of Open Access Journals (Sweden)

    Sarah J. Clark MPH

    2014-11-01

    Full Text Available Purpose. To describe the perspectives of general dentists regarding oral health care for children ≤3 years. Methods. Mailed survey of 444 general dentists in Michigan. Results. Although most dentists were aware of recommendations for early dental visits, only 36% recommended their own patients begin dental visits by 1 year of age. Only 37% dentists felt that screening for oral health problems can be done by medical providers, whereas 34% agreed administration of fluoride varnish by medical providers would be effective in preventing dental problems in young children. Conclusions. Dentists’ failure to recommend 1-year dental visits is due neither to lack of awareness nor to capacity problems. The limited enthusiasm for involving children’s medical providers in oral health promotion signals attitudinal barriers that must be overcome to improve children’s oral health. Primary care providers should identify and refer to dentists in their community who are willing to see young children.

  9. Stigma and difficulty accessing medical care in a sample of adults with serious mental illness.

    Science.gov (United States)

    Ostrow, Laysha; Manderscheid, Ron; Mojtabai, Ramin

    2014-11-01

    Wellness of people with mental illness is increasingly a public health priority. This study examined factors associated with difficulties receiving medical care in adults with mental illness. In a sample of 1,670 adults with mental illness, we assessed difficulties in accessing medical care and stigma. A total of 465 (28%) participants reported difficulties in accessing medical care; 211 (13%) attributed difficulties in access to stigma. Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.

  10. Taking care of your vascular access for hemodialysis

    Science.gov (United States)

    ... take your blood pressure, start an IV (intravenous line), or draw blood from your access arm. DO NOT let anyone draw blood from your tunneled central venous catheter. DO NOT sleep on your access arm. ...

  11. Barriers of access to oral health care among university students in southern Colombia, 2011. A multivariate analysis

    Directory of Open Access Journals (Sweden)

    Anderson Rocha-Buelvas

    2014-10-01

    Full Text Available Background. The right to health is considered to be a fundamental human right. Therefore, it is a starting point from which to combat unjust and immoral inequalities. It is essential to study the process through which a need for attention is completely satisfied. Objective. To analyze determinants of access to oral health care among university students in municipality of Pasto. Materials and methods. A sample of 338 university students answered a confidential survey that was based upon previous studies using a health care services utilization behavioral model. Results. In terms of enabling factors, the students that responded as ‘having a bad health state’ were those that used oral health care services the most in last year, while those students that responded as "being dissatisfied with the appearance of their teeth’ used oral health care services less. In relation to need factors, the students whose quality of life was not affected by physical impairment and physical pain used oral health care services less. Predisposing factors were not statistically significant. Conclusions. This study found that enabling and need factors were associated with recent dental consultations by university students in the municipality of Pasto.

  12. Dental care provided to sickle cell anemia patients stratified by age: A population-based study in Northeastern Brazil

    Science.gov (United States)

    Costa, Cyrene Piazera Silva; Aires, Bárbara Tamires Cruz; Thomaz, Erika Bárbara Abreu Fonseca; Souza, Soraia de Fátima Carvalho

    2016-01-01

    Objective: To assess differences in the dental care provided to sickle cell anemia (SCA) patients depending on age. This retrospective study used secondary data from the dental records of the Center of Hematology and Hemotherapy in Maranhão (HEMOMAR). Materials and Methods: Data were obtained from 574 dental records of patients with SCA treated or under treatment in the Dental Department of HEMOMAR from 2000 to 2011. Data on the gender, age, duration of dental treatment, number of patients submitted to periodontal treatment (PT), number of filled teeth (FT), teeth extracted (EX), endodontically treated teeth (ET), and reason for the dental procedures were collected. The Kruskal–Wallis test together with Dunn's post hoc test, Chi-square test, and Spearman's correlation was used for statistical analysis. An alpha error of 5% was considered acceptable. Results: Significant differences were found for FT, EX (P dental caries (100%) and irreversible pulpitis (55.6%), respectively. The main reasons for teeth extractions were residual roots (21.3%), chronic apical periodontitis (19.7%), and crown destruction (19.3%). There were positive correlations between age and EX (r = 0.93; P = 0.025) and ET (r = 0.92; P = 0.028). Conclusions: FT, ET, EX, and PT procedures become more common in older patients. Tooth decay is the main reason for dental treatment in SCA patients. PMID:27403053

  13. Dental Issues & Down Syndrome

    Science.gov (United States)

    ... Associated Conditions » Dental Issues & Down Syndrome Dental Issues & Down Syndrome Dental care is important for everybody, but people ... is Different About the Teeth of People With Down Syndrome? Delayed Eruption The teeth of people with Down ...

  14. Association between depressive symptoms and dental care-seeking behavior among elderly Brazilian people

    Directory of Open Access Journals (Sweden)

    Gabriela Ádima de Camargo ÁVILA

    Full Text Available Abstract Background Depressive symptoms are highly prevalent among the elderly population (10%. These symptoms frequently appear when there is a loss of quality of life associated with social exclusion and the appearance of severe diseases. Feelings of sadness, discouragement, despondency and deception, and events such as the loss of close friends and family can also be related to these symptoms. The consequences of depressive symptoms include negative oral health outcomes, such as a decrease in the frequency of toothbrushing, greater prevalence of caries and higher probability of the appearance of periodontitis. Aim This study aimed to evaluate the association between the presence of depressive symptoms and problem-oriented oral healthcare behavior, as well as the absence of healthcare-seeking behavior. Material and method 872 elderly people living in two health districts in Porto Alegre were evaluated. They provided information on socioeconomic variables at an interview, and responded to the Geriatric Depression Scale-15 and to a questionnaire assessing dental care-seeking behavior. In addition, an oral examination was performed. When analyzed using Poisson regression with robust variance, the variables of male sex, less schooling, lower income, reduced number of teeth, presence of root remnants and presence of depressive symptoms were found to be independently associated with the outcome. Result There was a significant difference regarding dental care-seeking behavior in relation to elderly people presenting depressive symptoms and those in low socioeconomic strata having poor oral status. Conclusion It was concluded that these factors need to be taken into consideration when evaluating dental care-seeking behavior.

  15. Access to health care for undocumented migrants from a human rights perspective:

    DEFF Research Database (Denmark)

    Biswas, Dan; Toebes, Brigit; Hjern, Anders

    2012-01-01

    Undocumented migrants' access to health care varies across Europe, and entitlements on national levels are often at odds with the rights stated in international human rights law. The aim of this study is to address undocumented migrants' access to health care in Denmark, Sweden, and the Netherlands...

  16. Access to health care for undocumented migrants from a human rights perspective:

    DEFF Research Database (Denmark)

    Biswas, Dan; Toebes, Brigit; Hjern, Anders

    2012-01-01

    Undocumented migrants' access to health care varies across Europe, and entitlements on national levels are often at odds with the rights stated in international human rights law. The aim of this study is to address undocumented migrants' access to health care in Denmark, Sweden, and the Netherlands...... from a human rights perspective....

  17. Effect of Aloe Vera mouthwash on dental plaque index in patients with endotracheal tube hospitalized in intensive care unite

    Directory of Open Access Journals (Sweden)

    Nasrin Mirbastegan

    2016-06-01

    Full Text Available Introduction: Oral health is an important aspect of caring for hospitalized patients in intensive care unit (ICU. Typically, 48 hours after admission to Intensive care unit, there is a change in mouth flora and dental plaque will be created subsequently. These events make an ideal environment for microbial growth. The aim of this study was to determine the effect of Aloe Vera mouthwash on dental plaque index in patients with tracheal intubation at ICU. Material and Methods: This randomized double blind trail was performed on 79 patients with Tracheal intubation at ICU. Data were gathered using purposive sampling. Participant divided in to the two groups. The experimental group received Aloe Vera mouth wash and control group received Normal Saline mouth wash. The study period was four days. O’leary Plaque index used for collecting data. Kolmogorov-Smirnov, Chi square, paired t-test and independent ttest were used for analyzing data by SPSS 20. Result: The experimental and control groups had similar characteristics except gender. The experimental dental plaque index (56.58±11.91 and Control dental plaque index (56.04±10.46 were similar. The dental plaque index had a significant decrease in experimental group (57.51±9.08 comparing to the control group (62.46±9.46. Conclusion: Aloe Vera mouth wash along with tooth brushing have a significant effect on reducing dental plaque index.

  18. Reforming dental workforce education and practice in the USA.

    Science.gov (United States)

    Davidson, P L; Nakazono, T T; Carreon, D C; Gutierrez, J J; Shahedi, S; Andersen, R M

    2011-05-01

    The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.

  19. Accessibility to primary health care services in the state of Goiás

    Directory of Open Access Journals (Sweden)

    Juliana Pires Ribeiro

    2015-09-01

    Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

  20. Developing core dental public health competencies for predoctoral dental and dental hygiene students.

    Science.gov (United States)

    Mascarenhas, Ana Karina; Atchison, Kathryn Ann

    2015-01-01

    Dental professionals are an "underutilized" workforce, when it comes to advocating for prevention and wellness in populations. The goal of this HRSA-funded project is to develop dental public health (DPH) competencies and curriculum for US predoctoral dental and dental hygiene programs. These competencies and accompanying curriculum are designed to better prepare the oral health workforce to meet the needs of the entire population, including the chronically underserved, those challenged by poor health literacy, or communities encountering barriers to accessing oral health care. By increasing the DPH competency of all graduating dental providers, in population-based approaches to preventing oral diseases rather than the existing exclusive focus on treatment, the number of providers who can respond to a population or the public's unmet needs and challenges, both in private practices and publicly supported clinics, will increase. This paper describes the competency development process and the eight competencies that were identified.

  1. How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian Context.

    Science.gov (United States)

    Snyder, Jeremy; Johnston, Rory; Crooks, Valorie A; Morgan, Jeff; Adams, Krystyna

    2017-06-01

    Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: (1) Inbound medical tourism to Canada's public hospitals; (2) Inbound medical tourism to a First Nations reserve; (3) Canadian patients opting to go abroad for medical tourism; and (4) Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system.

  2. HIV transmission in the dental setting and the HIV-infected oral health care professional: workshop 1C.

    LENUS (Irish Health Repository)

    Flint, S R

    2011-04-01

    This workshop addressed two important issues: first, the global evidence of HIV transmission from health care provider to patient and from patient to health care provider in the general health care environment and the dental practice setting; second, in the era of highly active antiretroviral therapy, whether oral health care professionals living with HIV pose a risk of transmission to their patients and whether standard infection control is adequate to protect both the patient and the oral health care professional in dental practice. The workshop culminated in a general discussion and the formulation of a consensus statement from the participating delegates, representing more than 30 countries, on the criteria under which an HIV-infected oral health care professional might practice dentistry without putting patients at risk. This consensus statement, the Beijing Declaration, was agreed nem con.

  3. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    Science.gov (United States)

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

  4. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    Directory of Open Access Journals (Sweden)

    Severina Alice da Costa Uchôa

    2016-01-01

    Full Text Available Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%. Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000, availability (p=0.0000, coordination of care (p=0.0000, integration (p=0.0000 and supply (p=0.0000, verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.

  5. Knowledge, awareness, and practices of complementary and alternative medicine for oral health-care management among dental students

    Science.gov (United States)

    Newadkar, Ujwala Rohan; Chaudhari, Lalit; Khalekar, Yogita K

    2017-01-01

    Objective: The objective of this study is to assess the awareness and practices of complementary and alternative medicine (CAM) for oral health-care management among dental students. Materials and Methods: A cross-sectional study was conducted in 200 dental students of final year and internship selected by simple random sampling using a close-ended questionnaire. Results: Among the total respondents, 52% were females and 48% were males. Nearly, 14% of the students were not aware of the different categories of the CAM and 12% of them were not aware of its implication in oral health-care management. Conclusion: Majority of the students was aware of CAM, yet they do not follow the use of the same for their patient's oral health-care management. Hence, a small provision regarding the knowledge of CAM should be imposed under the undergraduate curriculum for the dental students so that it should be implemented in their practice in future.

  6. Access to general health care services by a New Zealand population with serious mental illness.

    Directory of Open Access Journals (Sweden)

    Wheeler A

    2014-03-01

    Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

  7. Patients' and carers' experiences of gaining access to acute stroke care: A qualitative study

    OpenAIRE

    Harrison, M; Ryan, T.; Gardiner, C.; Jones, A

    2012-01-01

    Background: Rapid access to acute stroke care is essential to improve stroke patient outcomes. Policy recommendations for the emergency management of stroke have resulted in signi ficant changes to stroke services, including the introduction of hyper-acute care. Objective: To explore patients' and carers' experiences of gaining access to acute stroke care and identify the factors that enabled or prevented stroke from being treated as a medical emergency. Methods: Qualitative semi-structured i...

  8. NHS dental care and the issues of public service ethos, governance, accountability and probity.

    Science.gov (United States)

    Batchelor, Paul

    2009-06-01

    A decision by any government to intervene in dental care requires that accountability arrangements exist and that the public has faith in them. Such arrangements require a range of governance mechanisms that in turn create routes of accountability. If accountability is to have meaning an appropriate probity system is necessary. Existing probity arrangements in the NHS dental care system are far from ideal: the checks on claims are far less vigorous than under the previous contractual agreement. While the Dental Reference Service continues to refine its probity activities there are few, if any, assessments of the quality of diagnosis and treatment planning let alone the quality of the treatment provided, along with financial shortfalls. The nature of the contract introduced in April 2006 means that, even with compliance, its use as a quality assurance mechanism is substantially weaker. To address these shortfalls requires improvements in the governance arrangements a key element of which is clarity in accountability. Accountability provides an understanding of how a delivery system works, the pressures and incentives facing its actors and allows for better reform design and implementation. If a public dental service is to have excellent outcomes, be fair and equitable and offer value for money the present failings must be addressed. As has been identified in other public services: "...certain assumptions appear to be based on a belief that these standards were general throughout the public sector and would be maintained or adapted during periods of change. Little attention was given to what compromises the standards, how they are perceived and implemented across the public sector and who monitors or polices them, particularly in times of change." (Doig, 1995). The development of improved probity arrangements and a suitable contract through which the service delivered is specified would be a starting point. Perhaps then both the public and the profession can begin to

  9. Limited impact on health and access to care for 19- to 25-year-olds following the Patient Protection and Affordable Care Act.

    Science.gov (United States)

    Kotagal, Meera; Carle, Adam C; Kessler, Larry G; Flum, David R

    2014-11-01

    The Patient Protection and Affordable Care Act (PPACA) allowed young adults to remain on their parents' insurance until 26 years of age. Reports indicate that this has expanded health coverage. To evaluate coverage, access to care, and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds following PPACA implementation. Data from the Behavior Risk Factor Surveillance System and the National Health Interview Survey, which provide nationally representative measures of coverage, access to care, and health care use, were used to conduct the study among participants aged 19 to 25 years (young adults) and 26 to 34 years (adults) in 2009 and 2012. Self-reported health insurance coverage. Health status, presence of a usual source of care, and ability to afford medications, dental care, or physician visits. Health coverage increased between 2009 and 2012 for 19- to 25-year-olds (68.3% to 71.7%). Using a difference-in-differences (DID) approach, after adjustment, the likelihood of having a usual source of care decreased in both groups but more significantly for 26- to 34-year-olds (DID, 2.8%; 95% CI, 0.45 to 5.15). There was no significant change in health status for 19- to 25-year-olds compared with 26- to 34-year-olds (DID, -0.5%; 95% CI, -1.87 to 0.87). There was no significant change for 19- to 25-year-olds compared with 26- to 34-year-olds in the percentage who reported receiving a routine checkup in the past year (DID, 0.3%; 95% CI, -2.25 to 2.85) or in the ability to afford prescription medications (DID, -0.4%; 95% CI, -2.93 to 1.93), dental care (DID, -2.6%; 95% CI, -5.61 to 0.61), or physician visits (DID, -1.7%; 95% CI, -3.66 to 0.26). There was also no change in the percentage who reported receiving a flu shot (DID, 1.9; 95% CI, -1.93 to 4.93). Insured individuals were more likely to report having a usual source of care and a recent routine checkup and were more likely to be able to afford health care than uninsured individuals

  10. The Dental Needs of Army Family Members, 1986: Pilot Study

    Science.gov (United States)

    1990-05-10

    pediatric dentistry programs as well as larger families appear to value access to free dental care. Since the DoD had not announced details of its dental insu...Category of Care and by Age Group: --For Children (age 4-14): Diagnostic & Preventive $27-$80 Restorations, stainless steel crowns , and extractions (Basic... crowns , and extractions. Comprehensive services consist of basic care, space maintenance, and orthodon- tics. For youths and adults, average costs were

  11. Health care professionals' perspectives on oral care for long-term care residents: nursing staff, speech-language pathologists and dental hygienists.

    Science.gov (United States)

    Yoon, Minn N; Steele, Catriona M

    2012-06-01

    Oral health has been identified as a key factor in general health and systemic disease in long-term care populations. To optimise oral health of this population, it is important to understand the oral care perspectives held by health care professionals involved in oral care provision. To explore perspectives regarding oral care held by nursing staff, speech-language pathologists (SLPs) and dental hygienists (DHs) in long-term care institutions and to understand how their perspectives impact activities and processes involved in the delivery of oral care. A focus group methodology was utilised. Separate focus groups for each targeted profession were held. Transcribed data were analysed using constant comparative analysis. Daily oral health maintenance and monitoring was considered a role of nursing staff. SLPs and DHs have roles focusing on advocacy, education and supplemental care. Social factors motivate nursing staff to provide oral care, whereas factors related to the general health consequences of poor oral health underlined the motivations of SLPs and DHs. Education and training initiatives incorporating social aspects of oral health may be more effective for motivating nursing staff than approaches emphasising physical risk factors. Organisations can foster environments that support collaboration and communication amongst the members of multidisciplinary teams in order to promote oral health as a priority. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  12. Expanding a professional dental care system: experiences of Task Force 261 Multifunctional Medical Battalion during Operation Iraqi Freedom 07-09.

    Science.gov (United States)

    Christopher, Frank L; Smith, Gregory M; Cobb, James W; Patterson, Craig G; Smith, Mark A; Pollard, Jennifer A

    2008-01-01

    During Operation Iraqi Freedom 07-09, Task Force 261 Multifunctional Medical Battalion managed an extensive dental care system stretching throughout the Iraq theater of operations. We illustrate several of the unique challenges faced by Task Force 261's headquarters and its dental and area support companies, and describe the remedies emplaced by the Task Force. Personnel structure, the evacuation chain, supply and facility management, dental civil-military operations, detainee care, information technology applications, and public health initiatives are discussed in detail.

  13. Preparing the Future Dental Hygiene Workforce: Knowledge, Skills, and Reform.

    Science.gov (United States)

    Fried, Jacquelyn L; Maxey, Hannah L; Battani, Kathryn; Gurenlian, JoAnn R; Byrd, Tammi O; Brunick, Ann

    2017-09-01

    With the health care delivery system in transition, the way in which oral health care services are delivered in 2040 will inevitably change. To achieve the aims of reduced cost, improved access, and higher quality and to advance population wellness, oral health care will likely become a more integrated part of medical care. An integrated primary care system would better meet the needs of an increasingly diverse and aging U.S. population with uneven access to health care services. By 2040, trends suggest that a smaller proportion of dental hygienists will work in traditional solo dental offices; many more will practice with multidisciplinary health care teams in large-group dental and medical practices and in a variety of non-traditional community settings. This integration will require changes in how dental hygienists are educated. To shape the skill sets, clinical judgment, and knowledge of future practitioners, current dental hygiene curricula must be reexamined, redirected, and enhanced. This article examines some of the factors that are likely to shape the future of dental hygiene practice, considers the strengths and weaknesses of current curricula, and proposes educational changes to prepare dental hygienists for practice in 2040. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  14. Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

    Science.gov (United States)

    Popat, H; Thomas, K; Farnell, D J J

    2016-07-08

    Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.

  15. Undocumented Immigrants and Access to Health Care: Making a Case for Policy Reform.

    Science.gov (United States)

    Edward, Jean

    2014-02-01

    The growth in undocumented immigration in the United States has garnered increasing interest in the arenas of immigration and health care policy reform. Undocumented immigrants are restricted from accessing public health and social service as a result of their immigration status. The Patient Protection and Affordability Care Act restricts undocumented immigrants from participating in state exchange insurance market places, further limiting them from accessing equitable health care services. This commentary calls for comprehensive policy reform that expands access to health care for undocumented immigrants based on an analysis of immigrant health policies and their impact on health care expenditures, public health, and the role of health care providers. The intersectional nature of immigration and health care policy emphasizes the need for nurse policymakers to advocate for comprehensive policy reform aimed at improving the health and well-being of immigrants and the nation as a whole. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  16. Accessible health care for Roma: a gypsy's tale a qualitative in-depth study of access to health care for Roma in Ghent.

    Science.gov (United States)

    Hanssens, Lise G M; Devisch, Ignaas; Lobbestael, Janique; Cottenie, Barbara; Willems, Sara

    2016-02-29

    In general, vulnerable populations experience more problems in accessing health care. This also applies to the Roma-population. In the City of Ghent, Belgium, a relatively large group of Roma resides more or less permanently. The aim of this study is to explore the barriers this population encounters in their search for care. In this qualitative study using in-depth interviews the barriers to health care for the Roma in Ghent are explored. We interviewed 12 Roma and 13 professionals (volunteers, health care providers,...) who had regular contact with the Roma-population in Ghent. For both groups purposive sampling was used to achieve maximal variation regarding gender, age, nationality and legal status. The Roma-population in Ghent encounters various barriers in their search for care. Financial constraints, not being able to reach health care and having problems to get through the complexity of the system are some of the most critical problems. Another important finding is the crucial role of trust between patient and care provider in the care-giving process. Roma share several barriers with other minority groups, such as: financial constraints, mobility issues and not knowing the language. However, more distinctive for this group is the lack of trust in care providers and health care in general. As a result, restraint and lack of communication form serious barriers for both patient and provider in their interaction. In order to ensure equitable access for Roma, more emphasis should be on establishing a relationship of mutual respect and understanding.

  17. Inequity in access to cancer care: a review of the Canadian literature.

    Science.gov (United States)

    Maddison, André R; Asada, Yukiko; Urquhart, Robin

    2011-03-01

    Despite the policy and research attention on ensuring equitable access--equal access for equal need--to health care, research continues to identify inequities in access to cancer services. We conducted a literature review to identify the current state of knowledge about inequity in access to cancer health services in Canada in terms of the continuum of care, disease sites, and dimensions of inequity (e.g., income). We searched MEDLINE, CINAHL, and Embase for studies published between 1990 and 2009. We retrieved 51 studies, which examine inequity in access to cancer services from screening to end-of-life care, for multiple cancer types, and a variety of socioeconomic, geographic, and demographic factors that may cause concern for inequity in Canada. This review demonstrates that income has the most consistent influence on inequity in access to screening, while age and geography are most influential for treatment services and end-of-life care, even after adjusting for patient need. Our review also reports on methods used in the literature and new techniques to explore. Equitable access to cancer care is vitally important in all health systems. Obtaining information on the current status of inequities in access to cancer care is a critical first step toward action.

  18. Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) - a prospective study of ageing people in Norway and Sweden.

    Science.gov (United States)

    Gülcan, Ferda; Ekbäck, Gunnar; Ordell, Sven; Klock, Kristin S; Lie, Stein Atle; Åstrøm, Anne Nordrehaug

    2017-09-10

    To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen's model. Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data. Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only. In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.

  19. Explaining the link between access-to-care factors and health care resource utilization among individuals with COPD

    Directory of Open Access Journals (Sweden)

    Kim M

    2016-02-01

    Full Text Available Minchul Kim,1 Jinma Ren,1 William Tillis,2,3 Carl V Asche,1,4 Inkyu K Kim,5 Carmen S Kirkness1 1Department of Internal Medicine, Center for Outcomes Research, University of Illinois College of Medicine at Peoria, 2OSF St Francis Medical Center, 3Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, 4Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy, Chicago, IL, 5Battelle Memorial Institute, Atlanta, GA, USA Background: Limited accessibility to health care may be a barrier to obtaining good care. Few studies have investigated the association between access-to-care factors and COPD hospitalizations. The objective of this study is to estimate the association between access-to-care factors and health care utilization including hospital/emergency department (ED visits and primary care physician (PCP office visits among adults with COPD utilizing a nationally representative survey data. Methods: We conducted a pooled cross-sectional analysis based upon a bivariate probit model, utilizing datasets from the 2011–2012 Behavioral Risk Factor Surveillance System linked with the 2014 Area Health Resource Files among adults with COPD. Dichotomous outcomes were hospital/ED visits and PCP office visits. Key covariates were county-level access-to-care factors, including the population-weighted numbers of pulmonary care specialists, PCPs, hospitals, rural health centers, and federally qualified health centers. Results: Among a total of 9,332 observations, proportions of hospital/ED visits and PCP office visits were 16.2% and 44.2%, respectively. Results demonstrated that access-to-care factors were closely associated with hospital/ED visits. An additional pulmonary care specialist per 100,000 persons serves to reduce the likelihood of a hospital/ED visit by 0.4 percentage points (pp (P=0.028. In contrast, an additional hospital per 100,000 persons increases the

  20. Do new and traditional models of primary care differ with regard to access?

    Science.gov (United States)

    Miedema, Baukje; Easley, Julie; Thompson, Ashley E.; Boivin, Antoine; Aubrey-Bassler, Kris; Katz, Alan; Hogg, William E.; Breton, Mylaine; Francoeur, Danièle; Wong, Sabrina T.; Wodchis, Walter P.

    2016-01-01

    Abstract Objective To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access. Design An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey. Setting All 10 Canadian provinces. Participants A total of 759 practices and 7172 patients. Main outcome measures Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care. Results Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did. Conclusion Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their

  1. Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands.

    Science.gov (United States)

    de Jongh, Ad; van Houtem, Caroline; van der Schoof, Mariëlle; Resida, Gail; Broers, Dyonne

    2008-01-01

    The objective of this study was to assess the oral health status, treatment needs, and barriers to dental care of noninstitutionalized children in The Netherlands who have severe disabilities. The oral health status of 61 children (38% female; 4-12 years of age; M = 7.7, SD = 2.2), randomly selected from seven different daycare centers, was evaluated. Caretakers (n = 126) and dentists (n = 40) completed questionnaires concerning demographic information, oral hygiene, frequency of dental visits, and possible barriers to the daily oral care of the children. Of all the children, 57.4% had untreated caries (mean dmft/DMFT = 3.0; SD = 3.1). The proportion of caries-free children was 29.5%. In comparison to Dutch children, a significantly higher proportion of children with disabilities belonging to an ethnic minority did not receive any routine dental care (53.1% and 23.8%, respectively). Caretakers considered the noncooperation of their patients as the most troublesome aspect of their daily oral care (68%). Dentists considered communication problems as the most important barrier to treatment (75%). In conclusion, Dutch noninstitutionalized children with severe disabilities still receive a relatively low degree of quality dental care. This is particularly true for children from ethnic minority groups.

  2. Physical, mental and cognitive disabilities in relation to utilization of dental care services by nursing home residents.

    Science.gov (United States)

    Almomani, Fidaa M; Bani-Issa, Wegdan

    2017-05-01

    The main purpose of this study was to investigate factors affecting dental care utilization among nursing home residents in Jordan. A total of 221 subjects with a mean age of 62.4 years (121 males and 100 females) taken from among nursing home residents across Jordan were recruited and composed a convenience sample for this study. The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB), Disability of Arm, Shoulder, and Hand test (DASH) were administered and oral health status was assessed for all subjects and examined as expected correlates of dental care utilization among nursing home residents. The response rate was about 88%. One-third of residents suffered from total edentulism and most of the remaining dentate residents exhibited periodontal disease (90%). Of the dentate sample, 90% of residents had bleeding upon probing, 85% were diagnosed with tooth mobility, 88% had presence of dental calculus, and 30% were diagnosed with root caries. Of the denture wearers, 59.1 % reported having soreness with their dentures and 32% of denture wearers reported having poor quality dentures. MMSE score, suffering from tooth sensitivity and having diabetes mellitus were identified to be indicators for utilization of dental care services among the study population. Regular oral care, assessments, and rehabilitation services are considered to be limited for nursing home residents in Jordan. Based upon these findings, future interventions should address oral health among nursing home residents in Jordan. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  3. Spatial access disparities to primary health care in rural and remote Australia.

    Science.gov (United States)

    McGrail, Matthew Richard; Humphreys, John Stirling

    2015-01-01

    Poor spatial access to health care remains a key issue for rural populations worldwide. Whilst geographic information systems (GIS) have enabled the development of more sophisticated access measures, they are yet to be adopted into health policy and workforce planning. This paper provides and tests a new national-level approach to measuring primary health care (PHC) access for rural Australia, suitable for use in macro-level health policy. The new index was constructed using a modified two-step floating catchment area method framework and the smallest available geographic unit. Primary health care spatial access was operationalised using three broad components: availability of PHC (general practitioner) services; proximity of populations to PHC services; and PHC needs of the population. Data used in its measurement were specifically chosen for accuracy, reliability and ongoing availability for small areas. The resultant index reveals spatial disparities of access to PHC across rural Australia. While generally more remote areas experienced poorer access than more populated rural areas, there were numerous exceptions to this generalisation, with some rural areas close to metropolitan areas having very poor access and some increasingly remote areas having relatively good access. This new index provides a geographically-sensitive measure of access, which is readily updateable and enables a fine granulation of access disparities. Such an index can underpin national rural health programmes and policies designed to improve rural workforce recruitment and retention, and, importantly, health service planning and resource allocation decisions designed to improve equity of PHC access.

  4. Terminally ill African American elders' access to and use of hospice care.

    Science.gov (United States)

    Noh, Hyunjin; Schroepfer, Tracy A

    2015-05-01

    The underuse of hospice care by terminally ill African American elders suggests they are suffering when hospice care could offer quality end of life care. Guided by the Behavioral Model for Vulnerable Populations, this study sought understanding of structural barriers faced when seeking access to hospice care and reasons for using it when access is possible. Data was collected through interviews with 28 African American hospice patients. Themes from directed content analysis provide insights into strategies used to overcome access barriers posed by income, health insurance and administrative procedure, as well as the role religion, family, information and health beliefs played in using it. Distributing educational materials and addressing spiritual/religious concerns in choosing hospice care are key in promoting African Americans' use of hospice care.

  5. The political culture of healthcare: why substantial dental care in Canada is covered by government insurance only in Québec - lessons for the United States?

    Science.gov (United States)

    Flaer, P J; Younis, M Z; Benjamin, P L; Al-Hajeri, M

    2011-06-10

    This opinion paper explains the unique and favourable terms of dental health insurance coverage available to residents (both permanent and temporary) of the Province of Québec, Canada. In comparison, the United States and British Canada are the poor stepchildren of government-mediated provision of dental health coverage. The differences in dental healthcare provision between these regions are a question of culture - more specifically, of differing socio-political cultures and different perspectives on the importance of dental care. Lawmakers in the United States can learn from this policy of government-administered dental insurance that appears to work well in Québec.

  6. Oral health in Brazil: the challenges for dental health care models.

    Science.gov (United States)

    Chaves, Sônia Cristina Lima

    2012-01-01

    This paper discusses adult oral health in Brazil according to three perspectives: 1) the available epidemiological evidence about the population's oral-health-related epidemiological situation, especially adults and the elderly population, in relation to two high prevalence oral injuries (dental caries and tooth loss), 2) the main health care models for dealing with this situation, by analyzing the related historical processes in order to reveal the likely social, political and epidemiological implications of the different models, and 3) lastly, the possible challenges to Brazilian dentistry or collective oral health in overcoming these obstacles. The main results of the study indicate that, from an epidemiological point of view, Brazil is undergoing a transition in dental caries and tooth loss, which is not yet reflected in the profile of the elderly, but which is tentatively evidenced in young adults. Tooth loss remains high. Certain aspects of society's economic and political superstructure have an important impact on oral health indicators and existing inequalities. Oral health care models have a relative importance and must not be neglected. Vestiges of ideological movements, like preventive medicine, may explain the current impasse in collective oral health practices, such as the preeminence of Finalized Treatment (FT) in clinics and of preventive care in schools fostered by community-based programs. It is therefore important to develop conceptual, theoretical reflections and to increase the objects of intervention, their purposes and their modus operandi. The practice of dentistry according to these alternative models is still being constructed. New studies related to the different formats of these new practices are recommended.

  7. Systematic review of recent innovations in service provision to improve access to primary care

    Science.gov (United States)

    Chapman, Jenifer L; Zechel, Annegret; Carter, Yvonne H; Abbott, Stephen

    2004-01-01

    Background: In England, there are particularly pressing problems concerning access to adequate primary care services. Consequently, innovative ways of delivering primary care have been introduced to facilitate and broaden access. Aims: The aim of this study was to review the evidence of seven recent innovations in service provision to improve access or equity in access to primary care, by performing a systematic review of the literature. Design of study: Systematic review. Setting: Primary care in the United Kingdom (UK). Method: Seven electronic databases were searched and key journals were hand-searched. Unpublished and ‘grey’ literature were sought via the Internet and through professional contacts. Intervention studies addressing one of seven recent innovations and conducted in the UK during the last 20 years were included. Two researchers independently assessed the quality of papers. Results: Thirty studies (32 papers and two reports) were identified overall. Variation in study design and outcome measures made comparisons difficult. However, there was some evidence to suggest that access is improved by changing the ways in which primary care is delivered. First-wave personal medical services pilots facilitated improvements in access to primary care in previously under-served areas and/or populations. Walk-in centres and NHS Direct have provided additional access to primary care for white middle-class patients; there is some evidence suggesting that these innovations have increased access inequalities. There is some evidence that telephone consultations with GPs or nurses can safely substitute face-to-face consultations, although it is not clear that this reduces the number of face-to-face consultations over time. Nurse practitioners and community pharmacists can manage common conditions without the patient consulting a general practitioner. Conclusion: The evidence is insufficient to make clear recommendations regarding ways to improve access to primary

  8. Assessment of access to primary health care among children and adolescents hospitalized due to avoidable conditions

    Directory of Open Access Journals (Sweden)

    Ana Paula Scoleze Ferrer

    Full Text Available Introduction: Hospitalizations for ambulatory care-sensitive conditions (HACSC are considered an indicator of the effectiveness of primary health care (PHC. High rates of HACSC represent problems in the access or the quality of health care. In Brazil, HACSC rates are high and there are few studies on the factors associated with it. Objective: To evaluate the access to PHC offered to children and adolescents hospitalized due to ACSC and analyze the conditioning factors. Method: Cross-sectional study with a quantitative and qualitative approach. Five hundred and one (501 users (guardians/caregivers and 42 professionals of PHC units were interviewed over one year. Quantitative data were obtained using Primary Care Assessment Tool validated in Brazil (PCATool-Brazil, while qualitative data were collected by semi-structured interview. The independent variables were: age, maternal education, family income, type of diagnosis, and model of care offered, and the dependent variables were access and its components (accessibility and use of services. Results: Sixty-five percent (65.2% of hospitalizations were ACSC. From the perspective of both users and professionals, access and its components presented low scores. Age, type of diagnosis, and model of care affected the results. Conclusion: The proportion of HACSC was high in this population. Access to services is inappropriate due to: barriers to access, appreciation of the emergency services, and attitude towards health needs. Professional attitudes and opinions reinforce inadequate ideas of users reflecting on the pattern of service use.

  9. A Comparison of US and Japanese Dental Restorative Care Present on Service Members Recovered from the WWII Era.

    Science.gov (United States)

    Shiroma, Calvin Y

    2017-02-20

    The documentation of dental materials used in the USA during the WWII era is readily available, while references for the Japanese are minimal. It was therefore important to build a photographic database of Japanese restorative care which could be utilized as a comparison tool for the deployed odontologist. The dental restorative care of approximately 400 US and 100 Japanese sets of remains was evaluated. Both countries share many similar restorative techniques to include collared crowns, full-coverage restorations, cantilever bridge/pontics to close spaces; restorative materials such as amalgam, gold, and zinc phosphate (temporary) restorations; and removable prostheses. The dental restorative materials most commonly used by US dentists include the amalgam and silicate cement, while the full-coverage crown was the type of restoration most frequently seen on the Japanese remains. Silicates, porcelain and replaceable crowns, and partial-coverage prepared crowns were not observed on the recovered Japanese remains.

  10. What are the barriers to access to mental healthcare and the primary needs of asylum seekers? A survey of mental health caregivers and primary care workers.

    Science.gov (United States)

    Bartolomei, Javier; Baeriswyl-Cottin, Rachel; Framorando, David; Kasina, Filip; Premand, Natacha; Eytan, Ariel; Khazaal, Yasser

    2016-09-29

    We aimed to assess the opinion of primary care workers, social workers, translators and mental health caregivers who work with asylum seekers about the latter's unmet needs and barriers to access to mental healthcare. We used a Likert scale to assess the opinion of 135 primary care workers (general practitioners, nurses, social workers and translators) and mental health caregivers about the proportion of asylum seekers with psychiatric disorders, their priority needs and their main barriers to mental health services. Insufficient access to adequate financial resources, poor housing and security conditions, access to employment, professional training and legal aid were considered as priority needs, as were access to dental and mental healthcare. The main barriers to access to mental healthcare for asylum seekers included a negative representation of psychiatry, fear of being stigmatized by their own community and poor information about existing psychiatric services. We found a good correlation between the needs reported by healthcare providers and those expressed by the asylum-seeking population in different studies. We discuss the need for greater mobility and accessibility to psychiatric services among this population.

  11. Relationships, Expertise, Incentives, and Governance: Supporting Care Home Residents' Access to Health Care. An Interview Study From England

    Science.gov (United States)

    Goodman, Claire; Davies, Sue L.; Gordon, Adam L.; Meyer, Julienne; Dening, Tom; Gladman, John R.F.; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C.

    2015-01-01

    Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. PMID:25687930

  12. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities

    Science.gov (United States)

    McKirnan, David J.; Du Bois, Steve N.; Alvy, Lisa M.; Jones, Kyle

    2013-01-01

    Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM ("N" = 871). The authors examined demographic differences in health care access and the relation between access and…

  13. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities

    Science.gov (United States)

    McKirnan, David J.; Du Bois, Steve N.; Alvy, Lisa M.; Jones, Kyle

    2013-01-01

    Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM ("N" = 871). The authors examined demographic differences in health care access and the relation between access and health-related…

  14. Current trends in use of intracanal medications in dental care facilities: questionnaire-based survey on training dental hygienists at educational institutions.

    Science.gov (United States)

    Furusawa, Masahiro; Yoshida, Takashi; Hosokawa, Souhei; Ariizumi, Yuugo

    2013-01-01

    The success of root canal therapy is dependent not only on removal of infected pulp (pulpectomy) followed by root canal enlargement, but also on the pharmacological effects of intracanal medications. Various intracanal medications are used. Formaldehyde preparations such as formocresol were common in the past, but these are no longer used in Europe or the US due to the biological toxicity of formaldehyde. In this study, a questionnaire was used to determine current trends in the use of intracanal medications at dental care facilities where dental hygiene students undergo practical training. The questionnaire comprised questions regarding the types of frequently used intracanal medications and their methods of application at dental care facilities in Saitama and Shizuoka prefectures. The results indicated that calcium hydroxide preparations were more commonly used in Europe or the US. However, these results also revealed that formaldehyde preparations were frequently used, which slightly differs from the scenario in Europe and the US. This study revealed that multiple intracanal medications were used for root canal therapy. Furthermore, it was also observed that cotton plugs were generally used as applicator tips for intracanal medications, whereas the use of absorbent paper points was relatively uncommon. The results suggest that the cost of absorbent paper points needs to be reduced.

  15. Factors influencing use of dental services in rural and urban communities: considerations for practitioners in underserved areas.

    Science.gov (United States)

    Heaton, Lisa J; Smith, Timothy A; Raybould, Ted P

    2004-10-01

    Individuals' utilization of dental services depends upon an array of factors, including access to care, financial restrictions, attitudes toward dental care, and dental fear. These factors, in turn, may vary across geographic locations and demographic groups. The goals of this study were to assess the use of dental services in both rural and urban areas of Kentucky and to examine challenges facing practitioners in rural areas. Individuals sampled from a rural population and patients in rural and urban dental clinics completed questionnaires about use of dental services, self-rated dental health, and dental fear. While these variables were strongly interrelated, differences emerged across locations. Patients in the urban area reported having more dental insurance but not better dental health. Patients in more rural areas reported seeking more emergency dental treatment but not more dental fear. While these factors are important considerations across locations, dental practitioners in rural areas in particular should be aware of barriers to dental care facing individuals in these areas. They have unique opportunities to provide education to their patients regarding the importance of dental care and the role of oral health in overall physical health.

  16. Participant recruitment to FiCTION, a primary dental care trial - survey of facilitators and barriers.

    Science.gov (United States)

    Keightley, A; Clarkson, J; Maguire, A; Speed, C; Innes, N

    2014-11-01

    To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team.

  17. Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands

    NARCIS (Netherlands)

    de Jongh, A.; van Houtem, C.M.H.H.; van der Schoof, M.; Resida, G.; Broers, D.

    2008-01-01

    The objective of this study was to assess the oral health status, treatment needs, and barriers to dental care of noninstitutionalized children in The Netherlands who have severe disabilities. The oral health status of 61 children (38% female; 4-12 years of age; M = 7.7, SD = 2.2), randomly selected

  18. Role of ethical beliefs and attitudes of dental students in providing care for HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Saad Ahmed Khan

    2017-01-01

    Conclusion: Dental students’ ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.

  19. The routine utilization of dental care during pregnancy in Eastern China and the key underlying factors: a Hangzhou City study

    NARCIS (Netherlands)

    Sun, W.; Guo, J.; Li, X.; Zhao, Y.; Chen, H.; Wu, G.

    2014-01-01

    Objectives Oral diseases are associated with adverse pregnancy outcomes. The routine utilization of dental care (RUDC) during pregnancy is an effective way to improve pregnant women’s oral health, and thus safeguard the health of their babies. As China has one fifth of the world’s population, it is

  20. Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

    Science.gov (United States)

    Dyson, Kate; Kruger, Estie; Tennant, Marc

    2012-12-01

    This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  1. Access to HIV treatment and care for people who inject drugs in Kenya: a short report.

    Science.gov (United States)

    Guise, Andy; Rhodes, Tim; Ndimbii, James; Ayon, Sylvia; Nnaji, Obiora

    2016-12-01

    People who inject drugs (PWID) experience a range of barriers to HIV treatment and care access. The Kenyan government and community-based organisations have sought to develop HIV care for PWID. A principal approach to delivery in Kenya is to provide care from clinics serving the general population and for this to be linked to support from community-based organisations providing harm reduction outreach. This study explores accounts of PWID accessing care in Kenya to identify care barriers and facilitators. PWID accounts were collected within a qualitative longitudinal study. In-depth interviews with PWID living with HIV (n = 44) are combined with interviews with other PWID, care providers and community observation. Results show that some PWID are able to access care successfully, whilst other PWID report challenges. The results focus on three principal themes to give insights into these experiences: the hardship of addiction and the costs of care, the silencing of HIV in the community and then discrimination and support in the clinic. Some PWID are able to overcome, often with social and outreach support, barriers to clinic access; for others, the challenges of addiction, hardship, stigma and discrimination are too constraining. We discuss how clinics serving the general population could be further adapted to increase access. Clinic-based care, even with community links, may, however, be fundamentally challenging for some PWID to access. Additional strategies to develop stand-alone care for PWID and also decentralise HIV treatment and care to community settings and involve peers in delivery should be considered.

  2. The role of social marketing in understanding access to primary health care services: perceptions and experiences.

    Science.gov (United States)

    Akinci, Fevzi; Healey, Bernard J

    2004-01-01

    Using the concept of social marketing, this study examined the determinants of access to primary health care services in order to better understand the perceived access problems and unmet service needs of an entire city in Northeastern Pennsylvania. Consistent with previous research, lack of access to health insurance coverage represents an important financial barrier to access to health care services in this community. This study also highlights the role of perceived need in explaining the presence or absence of a physician consultation.While increased attention to access issues at the national level is important, there also needs to be more emphasis on collecting local data for local decision-making regarding access issues.

  3. Cultivating professional responsibility in a dental hygiene curriculum.

    Science.gov (United States)

    Blue, Christine M

    2013-08-01

    To prepare dental hygienists for future roles in the health care system, dental hygiene education must prepare graduates with skills, ethics, and values that align with professional responsibility. The objective of this study was to determine the effectiveness of curricular changes designed to develop professional identity and responsibility over the entire span of the dental hygiene curriculum. Twenty-four dental hygiene students at the University of Minnesota were surveyed about their attitudes toward access to dental care, society's and health professionals' responsibility to care for the underserved, and their personal efficacy to provide care for the underserved. Surveys were conducted at three time points in the curriculum. The Attitudes Toward Health Care instrument adapted by Holtzman for dental use was used to survey the students. The findings indicate that this institution's curricular changes were effective in cultivating professional responsibility among these students. Their attitude scores increased across the six-semester curriculum, and students in their last semester of the program believed that all individuals have a right to dental care and that society has an obligation to provide dental care. These students' sense of obligation to care for the needy became stronger and their perceptions of their own ability to impact the community and act as an agent of change also increased.

  4. Cognitive Impairment, Oral Self-care Function and Dental Caries Severity in Community-dwelling Older Adults

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer JJ; Chen, Hong; Naorungroj, Supawadee

    2013-01-01

    Objective To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults. Background Cognitive impairment significantly affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients. Materials and methods Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots. Results Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults. PMID:23758583

  5. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

    OpenAIRE

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the Univ...

  6. Racial and Ethnic Variations in Preventive Dental Care Utilization among Middle-aged and Older Americans, 1999-2008

    Directory of Open Access Journals (Sweden)

    Bei eWu

    2013-12-01

    Full Text Available Objective: This study examined recent trends of preventive dental care utilization among Americans aged 50 and above, focusing on variations across racial and ethnic groups including Whites, Blacks, Hispanics, American Indians/Alaska Natives, and Asians. Methods: Self-reported information on oral health behaviors was collected from 644,635 participants in the Behavioral Risk Factor Surveillance System (BRFSS between 1999 and 2008.Results: Despite a significant upward trend of frequency of dental cleaning from 1999 to 2008 (OR=1.02, in 2008 still only 56 to 77% of any ethnic or racial group reported having had a dental cleaning in the previous 12 months. Relative to Whites, Blacks (OR=.64 were less likely to have a dental cleaning in the previous 12 months. These variations persisted even when SES, health conditions, health behaviors, and number of permanent teeth were controlled. In contrast, Hispanics, Asians, and American Indians/Alaskan Natives did not differ from Whites in dental cleanings. Discussion: This is the first study to provide national estimates of the frequency of dental cleaning and associated trends over time for five major ethnic groups aged 50 and above in the U.S. simultaneously. Our findings suggest that public health programs with an emphasis on educating middle-aged and older minority populations on the benefits of oral health could have a large impact, as there is much room for improvement. Given the importance of oral health and a population that is rapidly becoming older and more diverse, the need for improved dental care utilization is significant.

  7. Developing a composite index of spatial accessibility across different health care sectors: A German example.

    Science.gov (United States)

    Siegel, Martin; Koller, Daniela; Vogt, Verena; Sundmacher, Leonie

    2016-02-01

    The evolving lack of ambulatory care providers especially in rural areas increasingly challenges the strict separation between ambulatory and inpatient care in Germany. Some consider allowing hospitals to treat ambulatory patients to tackle potential shortages of ambulatory care in underserved areas. In this paper, we develop an integrated index of spatial accessibility covering multiple dimensions of health care. This index may contribute to the empirical evidence concerning potential risks and benefits of integrating the currently separated health care sectors. Accessibility is measured separately for each type of care based on official data at the district level. Applying an Improved Gravity Model allows us to factor in potential cross-border utilization. We combine the accessibilities for each type of care into a univariate index by adapting the concept of regional multiple deprivation measurement to allow for a limited substitutability between health care sectors. The results suggest that better health care accessibility in urban areas persists when taking a holistic view. We believe that this new index may provide an empirical basis for an inter-sectoral capacity planning.

  8. Expanding access to rheumatology care: the rheumatology general practice toolbox.

    Science.gov (United States)

    Conway, R; Kavanagh, R; Coughlan, R J; Carey, J J

    2015-02-01

    Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant's confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant's self-assessed competence in diagnosis and management of common rheumatic diseases.

  9. Open access policy at Reviews in Health Care

    Directory of Open Access Journals (Sweden)

    Silvia Maina

    2011-07-01

    Full Text Available [The abstract of this article is not available. Here are the first sentence of the interview with Peter Suber. The complete interview is freely available upon registration]Peter Suber (http://bit.ly/suber is Berkman Fellow at Harvard University, Senior Researcher at SPARC, the Open Access Project Director at Public Knowledge, and Research Professor of Philosophy at Earlham College. He conducts research, writing, consulting, and advocacy on open access and related topics.Q: The aim of open access is to remove access barriers to publication. Don’t you think that fee-based model can be an obstacle for authors in less-developed countries?A: Fee-based OA journals don’t work as well as no-fee OA journals in fields and countries where most research is unfunded. But it’s important to remember that the vast majority of OA journals (70% charge no publication fees at all. The percentage is even higher for OA journals published in developing countries. For example, nearly all the OA journals published in India are no-fee. It’s equally important to remember that green OA, or OA through repositories, is an inexpensive alternative to gold OA, or OA through journals.

  10. Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study.

    Science.gov (United States)

    Nicol, Pam; Al-Hanbali, Arwa; King, Nigel; Slack-Smith, Linda; Cherian, Sarah

    2014-06-13

    Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children. Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software. There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents' previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees' difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed. The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already

  11. Tooth agenesis in patients referred to an Irish tertiary care clinic for the developmental dental disorders.

    LENUS (Irish Health Repository)

    Hashem, Atef A

    2010-01-01

    PURPOSE: This study was carried out to determine the prevalence, severity and pattern of hypodontia in Irish patients referred to a tertiary care clinic for developmental dental disorders. MATERIALS AND METHODS: Details of 168 patients with hypodontia referred during the period 2002-2006 were entered in a database designed as a national record. Tooth charting was completed using clinical and radiographic examinations. The age of patients ranged from 7-50 years, with a median age of 20 years (Mean: 21.79; SD: 8.005). RESULTS: Hypodontia referrals constituted 65.5% of the total referrals. Females were more commonly affected than males with a ratio of 1.3:1. The number of referrals reflected the population density in this area; the majority were referrals from the public dental service. Mandibular second premolars were the most commonly missing teeth, followed by maxillary second premolars and maxillary lateral incisors; maxillary central incisors were the least affected. Symmetry of tooth agenesis between the right and left sides was an evident feature. Slightly more teeth were missing on the left side (n = 725) than on the right side (n = 706) and in the maxillary arch (n = 768) as compared to the mandibular arch (n = 663). Some 54% of patients had severe hypodontia with more than six teeth missing; 32% had moderate hypodontia, with four to six teeth missing. The most common pattern of tooth agenesis was four missing teeth. CONCLUSION: Hypodontia was a common presentation in a population referred to this tertiary care clinic. The pattern and distribution of tooth agenesis in Irish patients appears to follow the patterns reported in the literature.

  12. The Role of Ghrelin, Salivary Secretions, and Dental Care in Eating Disorders

    Directory of Open Access Journals (Sweden)

    Akio Inui

    2012-08-01

    Full Text Available Eating disorders, including anorexia and bulimia nervosa, are potentially life-threatening syndromes characterized by severe disturbances in eating behavior. An effective treatment strategy for these conditions remains to be established, as patients with eating disorders tend to suffer from multiple relapses. Because ghrelin was originally discovered in the stomach mucosa, it has been widely studied over the past decade in an effort to uncover its potential roles; these studies have shed light on the mechanism by which ghrelin regulates food intake. Thus, studying ghrelin in the context of eating disorders could improve our understanding of the pathogenesis of eating disorders, possibly resulting in a promising new pharmacological treatment strategy for these patients. In addition, early detection and treatment of eating disorders are critical for ensuring recovery of young patients. Oral symptoms, including mucosal, dental, and saliva abnormalities, are typically observed in the early stages of eating disorders. Although oral care is not directly related to the treatment of eating disorders, knowledge of the oral manifestations of eating disorder patients may aid in early detection, resulting in earlier treatment; thus, oral care might contribute to overall patient management and prognosis. Moreover, ghrelin has also been found in saliva, which may be responsible for oral hygiene and digestion-related functions. This review discusses the pharmacological potential of ghrelin in regulating food-intake and the role of saliva and oral care in young patients with eating disorders.

  13. Efficacy of Video-Assisted Instruction on Knowledge and Performance of Dental Students in Access Cavity Preparation

    Science.gov (United States)

    Naseri, Mandana; Shantiaee, Yazdan; Rasekhi, Javid; Zadsirjan, Saeede; Mojtahed Bidabadi, Maryam; Khayat, Akbar

    2016-01-01

    Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the small size of the oral cavity, students cannot closely observe the clinical procedure. Use of new teaching modalities such as the intraoral camera may obviate this problem. This study assessed the effect of video-assisted clinical instruction in dentistry (VACID) on dental student’s knowledge and performance in access cavity preparation during endodontic treatment. Methods and Materials: In this interventional study, twenty six undergraduate students were equally divided into two groups and received instructions on access cavity preparation via conventional demonstration (CD) or VACID using intraoral camera plus conventional demonstration. Students’ knowledge was assessed before and after the demonstration. The scores obtained by students were compared between the two groups. Data were analyzed using the Mann Whitney U test. Results: No significant difference was found between the two groups in knowledge and performance scores of students about pulp chamber removal, under-extension, over-extension, gouging, perforation or finding the main and extra canals. However, use of intraoral camera significantly reduced the number of student visits to instructors for problem solving (P=0.001). Conclusion: VACID is an effective educational method and as efficient as conventional demonstration in endodontics; as a result it can be used in combination with conventional teaching. PMID:27790265

  14. Efficiency of mobile dental unit in public health programs

    Directory of Open Access Journals (Sweden)

    Nitin Gupta

    2016-07-01

    Full Text Available Almost all dental Colleges run a mobile dental operation for people living in far inaccessible areas who are not able to avail dental care. Mobile dental clinics provide a mode of reaching the unreached by delivering dental care in areas where alternative i.e. private practitioners and fixed clinics are unavailable or inaccessible. Oral diseases account for high morbidity in the community which is compounded by the gross mal-distribution of provision of oral health services in India. In order to ensure accessibility to basic oral health services innovative models of service delivery are being explored. In this context the health economics of mobile oral health care is critically evaluated in this paper. Thus a cost analysis was undertaken to determine the operating expenses for the existing mobile dental unit. Requisite permission of Head of institution was obtained and data was extracted from the records of the mobile dental unit for the year 2014-15.Information on the operating expenses was collected. Costing was done using step down accounting method. Total operating cost of the unit for the year 2014-15 was Rs. 184888/-.Unit cost for each camp was Rs.3625/- and for each patient Rs.76/-. Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful cost analysis based on sound assumptions is of utmost importance.

  15. Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-08-22

    Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

  16. Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.

    Science.gov (United States)

    Walker, Evan; McMahan, Ryan; Barnes, Deborah; Katen, Mary; Lamas, Daniela; Sudore, Rebecca

    2017-09-21

    Documenting patients' advance care planning wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about advance care planning documentation practices in the electronic health record. Describe advance care planning documentation practices and the accessibility of documented discussions in the electronic health record. Participants were primary care patients at the San Francisco VA Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions. In this cross-sectional study, we assessed the prevalence of advance care planning documentation, including any legal forms/orders and discussions in the prior five years. We also determined accessibility of discussions (i.e., accessible centralized posting vs. inaccessible free-text in progress notes). The mean age of 414 participants was 71 years (SD ±8), 9% were women, 43% were non-white, and 51% had documented advance care planning including 149 (36%) with forms/orders and 138 (33%) with discussions. Seventy-four participants (50%) with forms/orders lacked accompanying explanatory documentation. Most (55%) discussions were not easily accessible, including 70% of those documenting changes in treatment preferences from prior forms/orders. Half of chronically ill, older participants had documented advance care planning, including one third with documented discussions. However, half of the patients with completed legal forms/orders had no accompanying documented explanatory discussions, and the majority of documented discussions were not easily accessible, even when wishes had changed. Ensuring that patients' preferences are documented and easily accessible is an important patient safety and quality improvement target to ensure patients' wishes are honored. Copyright © 2017. Published by Elsevier Inc.

  17. Structural violence and simplified paternalistic ideas of patient empowerment decreases health care access, quality & outcome for ethnic minority patients

    DEFF Research Database (Denmark)

    Sodemann, Morten

    Increasing complexity of health care organization, rapid hyperspecialization of medical care, lack of ’patient literacy’ and pressure on patients to take over responsibility, challenges political dreams of equal access to patient centered high quality secure care....

  18. Expanding access to rheumatology care: the rheumatology general practice toolbox.

    LENUS (Irish Health Repository)

    Conway, R

    2015-02-01

    Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant\\'s confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p < 0.05) in 11 of the 14 aspects assessed. The Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant\\'s self-assessed competence in diagnosis and management of common rheumatic diseases.

  19. Caring About Sharing: Couples’ Practices in Single User Device Access

    DEFF Research Database (Denmark)

    Jacobs, Maia; Cramer, Henriette; Barkhuus, Louise

    2016-01-01

    Most devices today are developed adhering to a one-user paradigm. Yet within households, couples are often sharing devices and accounts. In this paper we take an in-depth look at sharing practices and preferences of cohabiting couples, and discuss the nuances of existing practices surrounding...... accounts and devices. We present a qualitative interview and diary study with ten couples, consisting of 20 individual interviews, and individual 8-day diaries. Dichotomous access models do not reflect the sharing practices of our couples; in which intent, access, and utilization all characterized sharing...... behaviors. We present a detailed description of the intentional and unintentional sharing practices our participants used in their day to day interactions and discuss the different challenges that particularly one type of content pose in terms of issues of privacy. We discuss implications for accounts...

  20. Inequalities in access to medical care by income in developed countries.

    NARCIS (Netherlands)

    E.K.A. van Doorslaer (Eddy); C. Masseria (Cristina); A.H.E. Koolman (Xander)

    2006-01-01

    textabstractBACKGROUND: Most of the member countries of the Organization for Economic Cooperation and Development (OECD) aim to ensure equitable access to health care. This is often interpreted as requiring that care be available on the basis of need and not willingness or ability to pay. We sought

  1. Socio-economic status influences blood pressure control despite equal access to care

    DEFF Research Database (Denmark)

    Paulsen, M S; Andersen, M; Munck, A P

    2012-01-01

    OBJECTIVE: Denmark has a health care system with free and equal access to care irrespective of age and socio-economic status (SES). We conducted a cross-sectional study to investigate a possible association between SES and blood pressure (BP) control of hypertensive patients treated in general...

  2. Measuring access to primary health care: use of a GIS-based accessibility analysis

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-10-01

    Full Text Available Spatial analytical tools and analyses are key enabling instruments which can be used to efficiently plan for public-spaces such as healthcare facilities in a metropolitan context. Improving the levels of access to public-spaces through various...

  3. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda.

    Science.gov (United States)

    Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew

    2012-05-03

    Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be

  4. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

    Directory of Open Access Journals (Sweden)

    Bouchard Maryse

    2012-05-01

    Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct

  5. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

    Science.gov (United States)

    2012-01-01

    Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher

  6. Patient-reported outcomes for immediate identification of dental care needs

    NARCIS (Netherlands)

    Güneri, P.; Epstein, J.B.; Raber-Durlacher, J.E.; Çankaya, H.; Boyacıoğlu, H.; Barasch, A.

    2015-01-01

    Aim: Dental treatment is necessary in oncology patients since pre-existing oro-dental disease may influence cancer treatment and prognosis. This study investigated the applicability of two indices in reflecting the actual oral health status of 100 non-cancer patients who were admitted for dental com

  7. Patient-reported outcomes for immediate identification of dental care needs

    Directory of Open Access Journals (Sweden)

    Güneri Pelin

    2015-06-01

    Full Text Available Aim: Dental treatment is necessary in oncology patients since pre-existing oro-dental disease may influence cancer treatment and prognosis. This study investigated the applicability of two indices in reflecting the actual oral health status of 100 non-cancer patients who were admitted for dental complaints/routine controls.

  8. Access to HIV Care and Support Services for African American Transwomen Living with HIV

    Science.gov (United States)

    Wilson, Erin C.; Arayasirikul, Sean; Johnson, Kelly

    2014-01-01

    Low access to HIV care and support has led to survival rates for transwomen that are half that of other populations at risk for HIV. Within the population, HIV disproportionately impacts African American transwomen. Interventions to increase access to HIV care and support are needed to better serve those most affected and vulnerable within the population. We conducted a study of barriers and facilitators to care and support services for African American transwomen to fill a gap in the literature to improve access for this particularly impacted population. A total of 10 in-depth interviews were conducted with African American transwomen living with HIV who lived outside the metro area of San Francisco. Three overarching thematic topics emerged-gender stigma, peer, and institutional distrust - giving insight into African American transwomen's barriers to HIV care and support services. A number of factors within these themes impacted access, such as whether organizations offered gender-related care, the geography of organizations as it relates to safe transportation and location, confidentiality and trust of peers and organizations, and trauma. Specific instrumental, institutional and emotional supports are provided that that may increase access to care and support services for African American transwomen living with HIV. PMID:24817835

  9. Effects of physician joint ventures on health care costs, access, and quality: exploring some issues.

    Science.gov (United States)

    Ahern, M; Scott, E

    1992-01-01

    Increasingly, physicians are joint-venturing with health care businesses such as physical therapy centers, diagnostic imaging centers, ambulatory surgical centers, and other services. Simultaneously, outpatient costs have been rising. Theoretical and empirical evidence, including results of an exploratory survey of experts, indicate that these two events are linked. Specifically, joint ventures between referring physicians and health care businesses often appear to increase costs, increase utilization, reduce quality of care, and reduce access.

  10. Hand-held water fluoride analysis: An accessible caries prevention tool for dental professionals.

    Science.gov (United States)

    Quock, Ryan L; Yank, Stephanie W; Chan, Jarvis T

    2011-01-01

    This study sought to compare the relative accuracy of a commercially available hand-held water fluoride analysis unit with a standard laboratory bench-top fluoride-specific electrode/millivoltmeter apparatus, with the goal of identifying possible practical applications of the hand-held unit for preventive dentistry. The units analyzed identical gravimetrically prepared fluoride solutions ranging from 0.1 to 4.0 ppm. The average difference between the measurements from the hand-held unit and the nominal values of the fluoride solutions was 0.011 ppm (SD = 0.068), and the average difference between the hand-held unit's measurements and the bench-top unit's measurements was 0.030 ppm (SD = 0.115). T-test analysis demonstrated no statistical difference between measurements from the hand-held unit with either the nominal values of the fluoride solutions or the bench-top unit's measurements. Results indicate that the hand-held water fluoride analysis unit has an appropriate level of accuracy for the measurement of fluoride levels in drinking water samples by dental professionals.

  11. Direct access compared with referred physical therapy episodes of care: a systematic review.

    Science.gov (United States)

    Ojha, Heidi A; Snyder, Rachel S; Davenport, Todd E

    2014-01-01

    Evidence suggests that physical therapy through direct access may help decrease costs and improve patient outcomes compared with physical therapy by physician referral. The purpose of this study was to conduct a systematic review of the literature on patients with musculoskeletal injuries and compare health care costs and patient outcomes in episodes of physical therapy by direct access compared with referred physical therapy. Ovid MEDLINE, CINAHL (EBSCO), Web of Science, and PEDro were searched using terms related to physical therapy and direct access. Included articles were hand searched for additional references. Included studies compared data from physical therapy by direct access with physical therapy by physician referral, studying cost, outcomes, or harm. The studies were appraised using the Centre for Evidence-Based Medicine (CEBM) levels of evidence criteria and assigned a methodological score. Of the 1,501 articles that were screened, 8 articles at levels 3 to 4 on the CEBM scale were included. There were statistically significant and clinically meaningful findings across studies that satisfaction and outcomes were superior, and numbers of physical therapy visits, imaging ordered, medications prescribed, and additional non-physical therapy appointments were less in cohorts receiving physical therapy by direct access compared with referred episodes of care. There was no evidence for harm. There is evidence across level 3 and 4 studies (grade B to C CEBM level of recommendation) that physical therapy by direct access compared with referred episodes of care is associated with improved patient outcomes and decreased costs. Primary limitations were lack of group randomization, potential for selection bias, and limited generalizability. Physical therapy by way of direct access may contain health care costs and promote high-quality health care. Third-party payers should consider paying for physical therapy by direct access to decrease health care costs and

  12. Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan

    Directory of Open Access Journals (Sweden)

    Masuda Hitomi

    2009-10-01

    Full Text Available Abstract Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77 with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1 oral hygiene, 2 dietary habits and 3 perception of oral condition. The questionnaire was used as a part of the comprehensive assessment. Results Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P Conclusion The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care.

  13. [Health status and medical care accessibility of single, homeless persons].

    Science.gov (United States)

    Trabert, G

    1997-06-01

    some sense to be "undesirable" as patients. Medical care offers for homeless people must be re-examined and changed appropriately in accordance with the requirements of the patients and the acceptability of the measures. Health care for the homeless is sorely needed. It is an urgent necessity to create special low-level acceptance medical care institutions. This health care service should be made available to homeless persons at the places where they gather (to set up a mobile medical service, medical streetwork, medical care ambulances). The interdisciplinary theme approach, which integrates the skills of physicians, nurses and social workers, is an invaluable strategy for establishing though and continuous care. Without good health, homeless people cannot resolve their other basic problems; and people simply cannot be healthy if they do not have a stable place to live.

  14. Smile dental journal

    National Research Council Canada - National Science Library

    "Smile dental journal is quarterly issued, peer-reviewed open access journal. Subject coverage is dentistry, dealing with all specialties of dentistry, its management, besides dental health related subjects...

  15. [Access to quality primary care for LGBT people].

    Science.gov (United States)

    Bize, Raphaël; Volkmar, Erika; Berrut, Sylvie; Medico, Denise; Balthasar, Hugues; Bodenmann, Patrick; Makadon, Harvey J

    2011-09-07

    This article offers a comprehensive approach to the health of lesbian, gay, bisexual and transgender (LGBT) people, where respect for diversity and non judgemental care play a central role. It calls for a health and medical vision that goes beyond HIV risk. For those who never had to question their own sexual orientation or gender identity, it is certainly difficult to understand how the discovery of one's identity trait in childhood or early adolescence can be transformed under social pressure into a burden which often remains invisible but is associated with considerable emotional and medical morbidity. This article raises the following question: How many LGBT patients go unnoticed every week, leaving the physician's office without an opportunity to receive appropriate listening, support and care?

  16. A register-based study of variations in services received among dental care attenders

    DEFF Research Database (Denmark)

    Rosing, Kasper; Hede, Børge; Christensen, Lisa Bøge

    2016-01-01

    . Materials and methods . This retrospective register-based study followed two Danish cohorts, aged 25 and 40, with a dental examination in 2009 (n = 32,351). The dental service data were registered during 2005–2009. The number of dental examinations, individual preventive services (IPS), tooth extractions......Objectives . To investigate whether receipt of dental services, among attenders, reflects variations in dental health or whether and to what degree it is associated with socioeconomic status, with irregular or regular dental attendance and with the availability of dentists in residential areas......, root fillings and composite fillings were analyzed in relation to socioeconomic status, irregular/regular dental attendance, inhabitant/dentist ratio and to DMFT at age 15 (DMFT15) and change in DMFT (ΔDMFT) from age 15 to age 25 and age 40, respectively. Poisson regression and negative binomial...

  17. Teledermatology Implementation in a VHA Secondary Treatment Facility Improves Access to Face-to-Face Care.

    Science.gov (United States)

    Raugi, Gregory J; Nelson, William; Miethke, Marion; Boyd, Marvin; Markham, Craig; Dougall, Brittany; Bratten, Dustin; Comer, Tara

    2016-01-01

    Teledermatology is a mainstream modality for delivering care in the Veterans Health Administration, especially in rural areas where access to traditional dermatology care is constrained. Previous investigations of the effect of teledermatology on improving patient access have focused largely on the metrics of visits avoided. However, the effect of teledermatology on improving patient access to face-to-face dermatology has not been well documented. The purpose of this study was to assess the impact of the implementation of store-and-forward teledermatology on access to face-to-face dermatology at the Mann-Grandstaff Spokane Veterans Administration (VA) Medical Center in Spokane, WA. Completed requests for dermatology and teledermatology consultation originating from the Spokane main facility from January 1, 2012 through June 30, 2013 were obtained from the Corporate Data Warehouse by SQL query. The numbers of consult requests and wait times for care for overall dermatology, face-to-face dermatology, and teledermatology were compared across the baseline, transition, and intervention periods. Within 6 months of implementation, the total number of requests for dermatology services increased by 40%. Access to face-to-face dermatology care improved, with a decrease in the duration of the interval between consultation request and consultation completion from a mean of 64.2 days to 20.3 days; overall access to dermatology (teledermatology and face-to-face dermatology) care improved with a decrease in the duration of the same from a mean of 61.2 days to 10.3 days. Implementation of a teledermatology program at the Mann-Grandstaff Spokane VA Medical Center improved access to face-to-face dermatology care.

  18. Challenges in access to and utilization of reproductive health care in Pakistan.

    Science.gov (United States)

    Ali, Moazzam; Bhatti, Mohammad Ayaz; Kuroiwa, Chushi

    2008-01-01

    Pakistan's maternal mortality rate is high, and adequate and timely emergency services could prevent most maternal deaths. A woman's right to life-saving services of skilled health care providers in childbirth is undeniable. This paper examines factors restricting women's access to emergency obstetric care services in Pakistan. This cross-sectional survey on emergency obstetric care services collected information at the health facility level using UN process indicators. The study enrolled 170 health facilities from nineteen randomly selected districts in Punjab and NWFP. Diverse factors limit women's access to Emergency Obstetric Care (EmOC) services. EmOC services were unavailable in most health facilities surveyed. Staff absenteeism, geographic remoteness, delayed access, and ambulance shortages jeopardize the transferral of seriously ill patients to higher level care facilities. Cultural norms dictate that women should be examined by women doctors, whose dearth makes these services inaccessible. Many maternal deaths would be avoidable if EmOC health services were accessible. The geographic obstacles to timely access, poor hospital infrastructure, and high staff absenteeism rates require immediate attention. Health facilities' working hours were inconsistent with the provision of around-the-clock essential services, depriving and endangering the lives of many in need. It is imperative to increase skilled female workers capable of managing EmOC problems through proper incentives. A focused approach at local levels through proper supervision, motivation, and management would unquestionably save women's lives.

  19. Spatial access to in-patient health care in northern rural India

    Directory of Open Access Journals (Sweden)

    Vikram Ranga

    2014-05-01

    Full Text Available Access to health care in rural areas is a major concern for local populations as well as for policy makers in developing countries. This paper examines spatial access to in-patient health care in northern rural India. In order to measure spatial access, impedance-based competition using the Three-Step floating Catchment Area (3SFCA method, a modification of the simple gravity model, was used. 3SFCA was chosen for the study of the districts of Pratapgarh and Kanpur Dehat in the Uttar Pradesh state and Vaishali in the Bihar state, two of India’s poorest states. This approach is based on discrete distance decay and also considers more parameters than other available methods, hence is believed to be a robust methodology. It was found that Vaishali district has the highest spatial access to in-patient health care followed by Pratapgarh and Kanpur Dehat. There is serious lack of health care, in Pratapgarh and Kanpur Dehat with 40% and 90% of the villages having shortage of in-patient care facilities in these respective districts. The most important factor affecting spatial access was found to be the distance to the nearest major urban agglomeration.

  20. Assessing the spatial accessibility of hospital care in Sichuan Province, China

    Directory of Open Access Journals (Sweden)

    Jay Pan

    2015-11-01

    Full Text Available Regional disparities in geographical access to hospital care are found throughout China. Understanding variations in the spatial accessibility of hospital care has the potential to provide decision support in healthcare planning. This study examines the hospital system in the Sichuan Province in China, which provides healthcare for more than 80 million people. We examine the impacts of accessibility characterisation via the conventional measurement approach by comparing the results to those derived using a floating catchment area approach. Employing a geographical information system based on population and hospital administrative data, we conducted a provincewide study of the spatial accessibility of hospital care in Sichuan Province, China. A shortest-path analysis and the enhanced two-step floating catchment area (E2SFCA method were implemented. Substantial differences between these two approaches were found, including a roughly 15% difference in the total number of under-served areas. Generally, spatial accessibility was higher in the eastern regions of Sichuan. More than 5.5 million people were found to have limited access, with large variations across the province. These results indicate that the official method used by policy makers in China may not capture the true nature of spatial accessibility throughout the region. We recommend that the E2SFCA method be implemented for health services research in China, providing decision makers with more accurate information when setting healthcare policies.

  1. Increasing access--a qualitative study of homelessness and palliative care in a major urban center.

    Science.gov (United States)

    Krakowsky, Yonah; Gofine, Mirriam; Brown, Pnina; Danziger, Jana; Knowles, Holly

    2013-05-01

    Rates of morbidity and mortality are significantly higher in homeless populations. Homeless people experience many barriers to receive adequate palliative care. This qualitative study examines how a major urban city's palliative care resources can be improved to increase access and better serve the homeless. Audiotaped interviews were preformed with 7 homeless care providers in Toronto, Canada, and their transcripts were analyzed using thematic analysis. The findings of the study suggest that in order to increase access and to serve the city's terminally ill homeless better, the following 4 areas must be addressed: (1) increasing positive interaction between the health care system and the homeless, (2) training staff to deal with the unique issues confronting the homeless, (3) providing patient-centered care, and (4) diversifying the methods of delivery.

  2. Serving Our Homeless Veterans: Patient Perpetrated Violence as a Barrier to Health Care Access

    Directory of Open Access Journals (Sweden)

    Luz M. Semeah

    2017-07-01

    Full Text Available In 2009, the Department of Veterans Affairs (VA set a goal to end veteran homelessness by 2015. Since then there has been a 36% reduction in homelessness due, in part, to the VA Supportive Housing (HUD-VASH program. These services include the receipt of home-based services to the veterans’ home. However, safety concerns and the threat of violence toward health care workers remain problematic in non-institutional care settings. This article discusses the concept of access to care and how safety concerns act as a barrier to services and optimal patient outcomes. Our study provides information on the prevalence of patient violence toward health care workers in the HUD-VASH program in a large veterans’ health system. Results suggest 70% of home-based service providers were exposed to violence and aggression. Providing services to veterans outside of institutional care settings, and the goal of eradicating homelessness among veterans, warrants further examination of access barriers.

  3. [Nature and magnitude of the need for dental care in Belgium: the point of view of dentists].

    Science.gov (United States)

    Gobert, Micheline; Deliège, Denise

    2007-01-01

    In most countries, oral and dental problems (decay, gingivitis, parodontitis,..) are frequent and impact on overall health. Such problems can often be avoided and treated. Health professionals and patients become gradually more aware of the importance of oral health. Oral hygiene and other measures may prevent several problems, which is beneficial to individuals and to public health, since the consequences of oral diseases are very expensive for all. Our study aims to analyze the features of the profession and to assess their possible evolution in the future. The design of our study combines two approaches: a quantitative study -based on data of the national health insurance scheme regarding utilization of care- and a qualitative study based on deep-interviews of dentists. According to the latter, dental care is expensive for the patient and also for professionals. The workload becomes heavier because patients expect too much. It is expanding, due to longer life expectancy and to medical progress which enables to conserve natural dentition, thus requiring extra care for the surviving teeth. These factors explain the increase of dental services which we highlight for the last 20 years; for the future, most of services are expected to expand, mainly for elderly (65 + years), One exception is noticeable: a probable decrease of "traditional care" for young and adult populations (hygiene; professionals denounce these gaps of the system and suggest improvements. Education about oral hygiene should also be promoted; consequently, the profession of oral hygienist should obtain an official license.

  4. Dental care knowledge and practices among secondary school adolescents in Ibadan North Local Government Areas of Oyo State, Nigeria

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    Tunde Joshua Ogunrinde

    2015-01-01

    Full Text Available Objective: To assess the dental care knowledge, and practice of secondary school adolescents in Ibadan North Local Government Area of Oyo State, Nigeria. Methodology: Four hundred and twelve secondary school adolescents were assessed using interviewer-administered questionnaire. Data on dental care knowledge and practice obtained through the questionnaire were analyzed using descriptive and inferential statistics with level of significance set at 5%. Result: Consumption of sticky, sugary and chocolaty food items was perceived by a majority (81.8% as unhealthy to dental health and 66.3% perceived consumption of fruits and vegetables as healthy to the teeth. Vertical brushing technique was mentioned by 69.7% of respondents as the best method of brushing the teeth, and 89.6% stated that teeth should be brushed twice daily. Majority 57.0% of respondents open caps of soft drink bottles with their teeth and 74.3% used toothpicks to remove food trapped in between teeth. Majority (82.8% perceived that dentist should be visited for check-up once in 6 months, however, only 31.6% of respondents had visited dentists before. There was a statistically significant relationship between tooth brushing technique and type of school attended by the respondents (P < 0.05. Conclusion: Majority of the respondents have good oral health knowledge but poor dental health practice.

  5. Introducing high-cost health care to patients: dentists' accounts of offering dental implant treatment.

    Science.gov (United States)

    Vernazza, Christopher R; Rousseau, Nikki; Steele, Jimmy G; Ellis, Janice S; Thomason, John Mark; Eastham, Jane; Exley, Catherine

    2015-02-01

    The decision-making process within health care has been widely researched, with shared decision-making, where both patients and clinicians share technical and personal information, often being cited as the ideal model. To date, much of this research has focused on systems where patients receive their care and treatment free at the point of contact (either in government-funded schemes or in insurance-based schemes). Oral health care often involves patients making direct payments for their care and treatment, and less is known about how this payment affects the decision-making process. It is clear that patient characteristics influence decision-making, but previous evidence suggests that clinicians may assume characteristics rather than eliciting them directly. The aim was to explore the influences on how dentists' engaged in the decision-making process surrounding a high-cost item of health care, dental implant treatments (DITs). A qualitative study using semi-structured interviews was undertaken using a purposive sample of primary care dentists (n = 25). Thematic analysis was undertaken to reveal emerging key themes. There were differences in how dentists discussed and offered implants. Dentists made decisions about whether to offer implants based on business factors, professional and legal obligations and whether they perceived the patient to be motivated to have treatment and their ability to pay. There was evidence that assessment of these characteristics was often based on assumptions derived from elements such as the appearance of the patient, the state of the patient's mouth and demographic details. The data suggest that there is a conflict between three elements of acting as a healthcare professional: minimizing provision of unneeded treatment, trying to fully involve patients in shared decisions and acting as a business person with the potential for financial gain. It might be expected that in the context of a high-cost healthcare intervention for which

  6. Unintentional overdose of analgesia secondary to acute dental pain.

    Science.gov (United States)

    Dodd, M D; Graham, C A

    2002-08-24

    Three cases of unintentional overdose with simple analgesics are presented. Over a two month period, these patients presented to the accident and emergency (A&E) department with acute dental pain, outside normal working hours, having been unable to access emergency dental care. In one case the patient's reason for attendance was to obtain further supplies of analgesics. The patients required admission for assessment of the severity of the overdose in addition to advice about appropriate use of analgesics and advice on access to dental care. None of the patients required treatment for the overdose. These cases serve as a timely reminder of the importance of taking an accurate drug history in emergency situations. They also raise issues of patient education for self medication and access to emergency dental services outside normal working hours.

  7. Need for and access to health care and medicines: are there gender inequities?

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    Anita K Wagner

    Full Text Available OBJECTIVE: Differences between women and men in political and economic empowerment, education, and health risks are well-documented. Similar gender inequities in access to care and medicines have been hypothesized but evidence is lacking. METHODS: We analyzed 2002 World Health Survey data for 257,922 adult respondents and 80,932 children less than 5 years old from 53 mostly low and middle-income countries. We constructed indicators of need for, access to, and perceptions of care, and we described the number of countries with equal and statistically different proportions of women and men for each indicator. Using multivariate logistic regression models, we estimated effects of gender on our study outcomes, overall and by household poverty. FINDINGS: Women reported significantly more need for care for three of six chronic conditions surveyed, and they were more likely to have at least one of the conditions (OR 1.41 [95% CI 1.38, 1.44]. Among those with reported need for care, there were no consistent differences in access to care between women and men overall (e.g., treatment for all reported chronic conditions, OR 1.00 [0.96, 1.04] or by household poverty. Of concern, access to care for chronic conditions was distressingly low among both men and women in many countries, as was access to preventive services among boys and girls less than 5 years old. CONCLUSIONS: These cross-country results do not suggest a systematic disadvantage of women in access to curative care and medicines for treating selected chronic conditions or acute symptoms, or to preventive services among boys and girls.

  8. Health care insurance, financial concerns in accessing care, and delays to hospital presentation in acute myocardial infarction.

    Science.gov (United States)

    Smolderen, Kim G; Spertus, John A; Nallamothu, Brahmajee K; Krumholz, Harlan M; Tang, Fengming; Ross, Joseph S; Ting, Henry H; Alexander, Karen P; Rathore, Saif S; Chan, Paul S

    2010-04-14

    Little is known about how health insurance status affects decisions to seek care during emergency medical conditions such as acute myocardial infarction (AMI). To examine the association between lack of health insurance and financial concerns about accessing care among those with health insurance, and the time from symptom onset to hospital presentation (prehospital delays) during AMI. Multicenter, prospective study using a registry of 3721 AMI patients enrolled between April 11, 2005, and December 31, 2008, at 24 US hospitals. Health insurance status was categorized as insured without financial concerns, insured but have financial concerns about accessing care, and uninsured. Insurance information was determined from medical records while financial concerns among those with health insurance were determined from structured interviews. Prehospital delay times ( 2-6 hours, or > 6 hours), adjusted for demographic, clinical, and social and psychological factors using hierarchical ordinal regression models. Of 3721 patients, 2294 were insured without financial concerns (61.7%), 689 were insured but had financial concerns about accessing care (18.5%), and 738 were uninsured (19.8%). Uninsured and insured patients with financial concerns were more likely to delay seeking care during AMI and had prehospital delays of greater than 6 hours among 48.6% of uninsured patients and 44.6% of insured patients with financial concerns compared with only 39.3% of insured patients without financial concerns. Prehospital delays of less than 2 hours during AMI occurred among 36.6% of those insured without financial concerns compared with 33.5% of insured patients with financial concerns and 27.5% of uninsured patients (P insured patients with financial concerns (adjusted odds ratio, 1.21 [95% confidence interval, 1.05-1.41]; P = .01) and with uninsured patients (adjusted odds ratio, 1.38 [95% confidence interval, 1.17-1.63]; P insurance and financial concerns about accessing care among

  9. Women's perceptions of access to prenatal care in the United States: a literature review.

    Science.gov (United States)

    Phillippi, Julia C

    2009-01-01

    Women report many barriers to accessing prenatal care. This article reviews the literature from 1990 to the present on women's perceptions of access to prenatal care within the United States. Barriers can be classified into societal, maternal, and structural dimensions. Women may not be motivated to seek care, especially for unintended pregnancies. Societal and maternal reasons cited for poor motivation include a fear of medical procedures or disclosing the pregnancy to others, depression, and a belief that prenatal care is unnecessary. Structural barriers include long wait times, the location and hours of the clinic, language and attitude of the clinic staff and provider, the cost of services, and a lack of child-friendly facilities. Knowledge of women's views of access can help in development of policies to decrease barriers. Structural barriers could be reduced through changes in clinic policy and prenatal care format, and the creation of child-friendly waiting and examination rooms. Maternal and societal barriers can be addressed through community education. A focus in future research on facilitators of access can assist in creating open pathways to perinatal care for all women.

  10. Using systematic change management to improve emergency patients' access to specialist care: the Big Squeeze.

    Science.gov (United States)

    Rafman, Heidi; Lim, Siang Ngin; Quek, Swee Chye; Mahadevan, Malcolm; Lim, Chanelle; Lim, Aymeric

    2013-06-01

    Delayed access to specialist care for emergency patients is associated with increased risk of morbidity and mortality, and increased patient anxiety. (1) To provide timelier access to inpatient and urgent outpatient specialist care for emergency patients. (2) To influence multiple stakeholders to modify their traditional practices and sustain changes. National University Hospital of Singapore, an academic medical centre with 997 beds in Singapore and over 34 sub-specialties. A set of six interventions was implemented to meet three goals: (1) provide timely access to urgent outpatient specialist care requested by the emergency department ED; (2) increase early inpatient discharges (in order to better match timing of emergency admissions); and (3) provide earlier defined care by inpatient specialists at the ED. An eight-step organisational change management plan was implemented to ensure all specialties complied with the changes. The goals were achieved. (1) Specialist outpatient appointments given within the timeframe requested by the ED doctor increased from 51.7% to 80.8%. (2) Early discharges increased from 11.9% to 26.6% and were sustained at 27.2%. (3) 84% of eligible patients received earlier defined specialist care at the ED. The change management achieved excellent clinician compliance rates ranging from 84% to 100%. However the median wait for admission remained unchanged. The interventions reduced the time for ED patients to access specialist outpatient and inpatient care. The systematic organisational change management approach resulted in sustained compliance.

  11. Determinants of unequal HIV care access among people living with HIV in Peru.

    Science.gov (United States)

    Silva-Santisteban, Alfonso; Segura, Eddy R; Sandoval, Clara; Girón, Maziel; Petrera, Margarita; Caceres, Carlos F

    2013-05-17

    Equity in access to health care among people living with HIV (PLHA) has not been extensively studied in Peru despite the fact there is significant social diversity within this group. We aimed to assess the extent to which health care provision to PLHA, including ARVT, was equitable and, if appropriate, identify factors associated with lower access. We conducted a survey among adult PLHA in four cities in Peru, recruited through respondent-driven sampling (RDS), to collect information on socio-demographic characteristics, social network size, household welfare, economic activity, use of HIV-related services including ARV treatment, and health-related out-of-pocket expenses. Between September 2008 and January 2009, 863 individuals from PLHA organizations in four cities of Peru were enrolled. Median age was 35 (IQR = 29-41), and mostly male (62%). Overall, 25% reported to be gay, 11% bisexual and 3% transgender. Most PLHA (96%) reported access to some kind of HIV-related health service, and 84% were receiving those services at a public facility. Approximately 85% of those reporting access to care were receiving antiretroviral treatment (ARV), and 17% of those not in treatment already had indication to start treatment. Among those currently on ARV, 36% percent reported out-of-pocket expenses within the last month. Transgender identity and age younger than 35 years old, were associated with lower access to health care. Our findings contribute to a better social and demographic characterization of the situation of PLHAs, their access to HIV care and their source of care, and provide an assessment of equity in access. In the long term, it is expected that HIV care access, as well as its social determinants, will impact on the morbidity and mortality rates among those affected by the HIV/AIDS epidemic. HIV care providers and program managers should further characterize the barriers to healthcare access and develop strategies to resolve them by means of policy change

  12. Mount Sinai Hospital dental program for persons with disabilities: role in undergraduate dental education.

    Science.gov (United States)

    Sigal, Michael J

    2010-01-01

    Access to dental care for persons with special needs or disabilities continues to be a problem. This population is known to have a high incidence of dental disease, but unfortunately oral health is a significant unmet health need in many cases. To address this need, the Mount Sinai Hospital Dental Program for Persons with Disabilities was developed over 30 years ago by staff within the discipline of pediatric dentistry at the faculty of dentistry of the University of Toronto. Undergraduate students receive hands-on clinical training in dental management of persons with disabilities, the majority of whom have a developmental disability and could receive care in a community-based dental practice. This program has been successful, but access to community care is still an issue for the population served. Two new initiatives have been introduced in an attempt to develop personal links between persons with disabilities and future dentists, the first a series of lectures given by persons with disabilities and the second a nonprofit organization dedicated to raising awareness of the need for dental care for persons with disabilities. Among other activities, the organization sponsors a community-based event called Sharing Smiles Day, which brings together dental students and persons with disabilities in a carnival-like setting where the emphasis is on personal interactions. Dental preventive education is also provided but is of secondary importance. These initiatives and the program as a whole represent recognition of the responsibility of educators to ensure that new graduates have both the education and the desire to provide needed dental care to persons with disabilities.

  13. ACCESS TO HEALTH CARE IN THE OUTPATIENT CLINICS OF ST. PETERSBURG AT THE PRESENT STAGE

    Directory of Open Access Journals (Sweden)

    M. G. Karaylanov

    2016-01-01

    Full Text Available The brief analysis of the organization of primary health care on an outpatient basis in the case ofSt. Petersburgis reflected. The structure of primary health care is described, namely healthcare organizations that provide outpatient care; the standards and the level of availability of primary health care, as well as the capacity of outpatient clinics are defined. An important criterion for the quality of care is its accessibility, taking into account the number of attached population. Reforming the ambulatory network in a large city is one of the most difficult health management problems, due to many factors, first of all determined by the needs of the population in primary health care, a variety of organizational forms of outpatient care, intensive changing residential area of the city, the need to ensure effective interactions with other social institutions.

  14. Adverse or acceptable: negotiating access to a post-apartheid health care contract.

    Science.gov (United States)

    Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

    2014-05-15

    As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires

  15. Retention in a public health care system with free access to treatment

    DEFF Research Database (Denmark)

    Helleberg, Marie; Engsig, Frederik N; Kronborg, Gitte;

    2012-01-01

    OBJECTIVE:: We aimed to assess retention of HIV infected individuals in the Danish health care system over a 15-year period. METHODS:: Loss to follow-up (LTFU) was defined as 365 days without contact to the HIV care system. Data were obtained from the nationwide Danish HIV Cohort study, The Danis......, especially after initiation of HAART. Absence from HIV care is associated with increased mortality. We conclude that high rates of retention can be achieved in a health care system with free access to treatment and is associated with a favorable outcome....

  16. Difficulties in accessing and availing of public health care systems among rural population in Chittoor District, Andhra Pradesh

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    Geetha Lakshmi Sreerama

    2015-01-01

    Full Text Available Context: Despite policies to make health care accessible to all, it is not universally accessible. Frequent evaluation of barriers to accessibility of health care services paves path for improvement. Hence, present study is undertaken to evaluate the factors and public health policies influencing health care access to rural people in Chittoor District, Andhra Pradesh, which can be interpolated for other regions. Aims: To assess knowledge, perceptions, availing of public health care services, barriers to health care access in Chittoor District, Andhra Pradesh. Settings and Design: Cross-sectional, hospital-based survey in the Government Maternity Hospital (GMH, Tirupati, a tertiary care center. Materials and Methods: Fifty women delivered normally in GMH through convenient sampling technique. Data collected on standardized pro forma as per IMS Institute of Healthcare Informatics. Statistical Analysis Used: Is done through MS Excel 2007, Epi Info 7 (of Centres for Disease Control and Prevention, Atlanta, USA and frequencies were described. Results: Distance, waiting hours, societal responsibility, nature of the illness, presumed commercialization of Medicare system, attitudes of health care providers, and loss of wages were not barriers for accessing health care. Accredited Social Health Activist (ASHA and availability of ambulance services made great improvements in health care accessibility. Absenteeism of health care providers is a problem. Conclusions: Expanding the ambulance services and ASHA network will be an effective measure for further accessibility to health care. Absenteeism of health care providers needs correction.

  17. Dental management of pediatric HIV patients--state of Israel, Ministry of Health Project at Rambam Health Care Campus, 2006-2011.

    Science.gov (United States)

    Yavnai, Nirit; Rosen-Walther, Anda; Pery-Front, Yael; Aizenbud, Dror

    2011-01-01

    Over two million children around the world are living with AIDS. Oral health and oral manifestations, such as dental caries and periodontitis, are important issues requiring focus when treating these children. Descriptive data of a project conducted at Rambam Hospital, financed by the Israeli Ministry of Health, are presented in order to investigate and characterize dental treatment for HIV infected children. Thirty-seven infected children, most originating from the Ethiopian community, participated in the project between 2006 and 2011. A total of 724 dental procedures during 185 dental appointments were performed successfully. These children should be provided proactive preventive dental care, while health service providers should undergo further training on prevention and early identification and management of orofacial manifestations. All dental and medical personnel should be made aware of this service in order to refer HIV infected children who can greatly benefit from this special program.

  18. Using geographic information system tools to improve access to MS specialty care in Veterans Health Administration.

    Science.gov (United States)

    Culpepper, William J; Cowper-Ripley, Diane; Litt, Eric R; McDowell, Tzu-Yun; Hoffman, Paul M

    2010-01-01

    Access to appropriate and timely healthcare is critical to the overall health and well-being of patients with chronic diseases. In this study, we used geographic information system (GIS) tools to map Veterans Health Administration (VHA) patients with multiple sclerosis (MS) and their access to MS specialty care. We created six travel-time bands around VHA facilities with MS specialty care and calculated the number of VHA patients with MS who resided in each time band and the number of patients who lived more than 2 hours from the nearest specialty clinic in fiscal year 2007. We demonstrate the utility of using GIS tools in decision-making by providing three examples of how patients' access to care is affected when additional specialty clinics are added. The mapping technique used in this study provides a powerful and valuable tool for policy and planning personnel who are evaluating how to address underserved populations and areas within the VHA healthcare system.

  19. The family-school-primary care triangle and the access to mental health care among migrant and ethnic minorities.

    Science.gov (United States)

    Gonçalves, Marta; Moleiro, Carla

    2012-08-01

    Understanding the concepts of mental health and help seeking behaviours of migrant and ethnic minority families constitutes an important step toward improving the intercultural competence of health and education professionals. This paper addresses these goals among ethnic and migrant minorities in Portugal. For this a multi-informant approach was selected. The study involved nine focus groups (N = 39) conducted with different samples: young immigrants (12-17 years), immigrant parents, teachers and health professionals. The results showed similarities and differences in concepts of mental health, as well as help seeking processes. Stigma continued to be recognized as a barrier in the access to mental health care. The paper argues that providing adequate training on mental health on cultural diversity competencies to health and education professionals can contribute to a better inter-communication and -relation system in the family-school-primary care triangle and thus facilitate access to mental health care for youth.

  20. The discourse of dental hygiene practice in Canada.

    Science.gov (United States)

    McKeown, L; Sunell, S; Wickstrom, P

    2003-02-01

    Recently the discourse in Canada relating to dental hygiene practice has changed. While dentistry still exercises controlling power over the public's oral cavity, dental hygienists have made inroads through legislative changes. A description of Canadian dental hygiene practice is provided to set the stage for a discussion about current discourse in the dental hygiene profession. Although power is often perceived as a shifting changing set of relations, these can be frozen in abstraction. It is rather like taking a photo of a single moment or event in an ongoing activity. This moment provides a starting point, an event that can be analysed. Four such events are evident in Canadian dental hygiene practice; they include, education, recognition of dental hygienists as primary care providers, the culture of dental hygiene and self-regulation. While all the events are important, self-regulation is critical to the viability and development of the profession. It is the central event that provides the backdrop for effecting change. With self-regulation comes responsibility and accountability for professional actions. It also provides possibilities for changing the discourse in oral care. As oral health care discourse is transformed through legislation and public awareness, the public will, hopefully, be able to directly access dental hygiene services, and dental hygienists themselves might increasingly recognise their importance as contributors in the health care system.

  1. Informal politics and inequity of access to health care in Lebanon

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    Chen Bradley

    2012-05-01

    Full Text Available Abstract Introduction Despite the importance of political institutions in shaping the social environment, the causal impact of politics on health care access and inequalities has been understudied. Even when considered, research tends to focus on the effects of formal macro-political institutions such as the welfare state. We investigate how micro-politics and informal institutions affect access to care. Methods This study uses a mixed-methods approach, combining findings from a household survey (n = 1789 and qualitative interviews (n = 310 in Lebanon. Multivariate logistic regression was employed in the analysis of the survey to examine the effect of political activism on access to health care while controlling for age, sex, socioeconomic status, religious commitment and piety. Results We note a significantly positive association between political activism and the probability of receiving health aid (p , with an OR of 4.0 when comparing individuals with the highest political activity to those least active in our sample. Interviews with key informants also reveal that, although a form of “universal coverage” exists in Lebanon whereby any citizen is eligible for coverage of hospitalization fees and treatments, in practice, access to health services is used by political parties and politicians as a deliberate strategy to gain and reward political support from individuals and their families. Conclusions Individuals with higher political activism have better access to health services than others. Informal, micro-level political institutions can have an important impact on health care access and utilization, with potentially detrimental effects on the least politically connected. A truly universal health care system that provides access based on medical need rather than political affiliation is needed to help to alleviate growing health disparities in the Lebanese population.

  2. Disability as a determinant of access to health care services in Colombia

    OpenAIRE

    2012-01-01

    The relationship between disability and poverty has been described in different contexts. Nevertheless, the basic characteristics of this relationship have not yet been fully established. The social exclusion and discrimination against people with disabilities increase the risk of poverty and reduce the access to basic opportunities such as health and education. This study examines the impact of a health limitation and poverty in the access to health care services in Colombia. Data from the C...

  3. Delays in Cancer Care Among Low-Income Minorities Despite Access

    Science.gov (United States)

    Nonzee, Narissa J.; Ragas, Daiva M.; Ha Luu, Thanh; Phisuthikul, Ava M.; Tom, Laura; Dong, XinQi

    2015-01-01

    Abstract Introduction: Narrowing the racial/ethnic and socioeconomic disparities in breast and cervical cancer requires an in-depth understanding of motivation for adherence to cancer screening and follow-up care. To inform patient-centered interventions, this study aimed to identify reasons why low-income women adhered to or delayed breast or cervical cancer screening, follow-up and treatment despite access to cancer care-related services. Methods: Semistructured qualitative interviews were conducted among women with access to cancer care-related services receiving care at an academic cancer center, federally qualified health centers, or free clinics in the Chicago metropolitan area. Transcripts were coded and analyzed for themes related to rationales for adherence. Results: Among 138 participants, most were African American (46%) or Hispanic (36%), English speaking (70%), and between ages 41 and 65 years (64%). Primary drivers of nonadherence included lack of knowledge of resources, denial or fear, competing obligations, and embarrassment. Facilitators included abnormality identification, patient activation, provider-initiated actions, and motivation from family or friends. Conclusions: Interventions targeting increased adherence to care among low-income and ethnic minority women should direct efforts to proactive, culturally and patient-informed education that enables patients to access resources and use the health care system, address misconceptions about cancer, ensure health care providers' communication of screening guidelines, and leverage the patient's social support network. PMID:26070037

  4. Access to infertility