成都市外国人口腔卫生服务利用的影响因素研究

doi:10.7518/hxkq.2018.04.014

华西口腔医学杂志 ›› 2018, Vol. 36 ›› Issue (4): 428-434.doi: 10.7518/hxkq.2018.04.014

成都市外国人口腔卫生服务利用的影响因素研究

陈稳¹(), 张笑涵², Shannon H Houser³, 周学东², 瞿星⁴()

1.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院头颈肿瘤外科
2.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院,成都 610041
3.美国阿拉巴马大学伯明翰分校卫生管理系,伯明翰 35205
4.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医学院口腔循证医学教研室,成都 610041

收稿日期:2018-03-15 修回日期:2018-06-02 出版日期:2018-08-01 发布日期:2018-08-01
作者简介:
陈稳,硕士,E-mail：1532044182@qq.com
基金资助:
四川大学青年教师基金（2016SCU11058）;牙防基金委大学生暑期实践项目（2016055）

Dental care utilization of immigrants in Chengdu, China

Wen Chen¹(), Xiaohan Zhang², H Houser Shannon³, Xue-dong Zhou², Xing Qu⁴()

1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
2. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
3. Dept. of Health Services Administration, School of Health Professions, Uni-versity of Alabama at Birmingham, Birmingham 35205, USA
4. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Evidence Based Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2018-03-15 Revised:2018-06-02 Online:2018-08-01 Published:2018-08-01
Supported by:
Young Teachers’ Research Fund of Sichuan University (2016SCU11058);Summer Practice Project of College Students of Dental Foundation (2016055).

摘要/Abstract

摘要：

目的调查中国成都市外国人的口腔卫生服务利用情况及其影响因素,为口腔卫生从业者对口腔卫生服务的国际化发展进行探索,为卫生政策制定者制定移民口腔健康政策提供建议。方法参照世界卫生组织制定的《成人口腔健康问卷》,结合安德森卫生服务利用模型设计问卷。问卷内容包括口腔健康情况、口腔保健意识、口腔健康保障和基本信息4个部分。采用方便抽样方法选择调查对象。调查结果使用SPSS 20.0统计软件分析,采用Binary Logistic回归和分层分析方法进行统计学分析。结果共有来自75个国家的654名调查对象完成调查,结果显示有102（15.6%）名外国人在成都曾经遇到过口腔问题却没有就诊。Binary Logistic回归分析显示,女性、长时间在成都居住、过去1年内出现过口腔健康问题、有使用牙线习惯、和家人一起居住在成都者遇到口腔问题或定期口腔体检时,更倾向于到本地口腔科就诊。通过ROC曲线分析,居住在成都10.5个月是外国人选择在成都就诊的临界值。结论卫生政策制定者可以根据不同居住时间的外国人制定不同的口腔急诊或平诊指南,创造出更方便外国人在成都因口腔问题就诊的环境,以促进外国人在成都的口腔卫生服务利用。

关键词: 口腔健康, 外国人, 口腔卫生服务利用, 成都市

Abstract:

Objective This study considered Chengdu, Sichuan, China as an example to investigate the dental service utilization by foreigners and its influencing factors. Results of the study can be referred by dental practitioners to explore international development of dental services and can be provided for health policy makers to formulate oral health policies for immigrants. Methods A simple random sampling method with a questionnaire was designed based on Anderson’s health utilization model and “Oral Health Questionnaire for Adults” by the World Health Organization. Oral health con-dition, consciousness, and demographic data were collected. Binary Logistic regression and stratified analysis with SPSS 20.0 were performed. Results A total of 654 immigrants repre-senting 75 countries participated in the study. Among all participants, 102 (15.6%) experienced dental problems while in resi-dence in China but paid no visit to dentists. Female immigrants, who spent considerable time living in Chengdu, experienced oral problems in a year, used dental floss, and reported family members in Chengdu, were more likely to visit Chinese dentists. Participants who lived in Chengdu for at least 10.5 months were the threshold distinguishing differences in dental visits in the country. Conclusion The policymakers in Chengdu should consider creating a convenient and conducive dental care environment for immigrants. Additional information related to urgent oral and routine care should be provided to short- and long-term living immigrants in China. Dental practitioners in China should also contemplate on collaborating with foreign dental insurance companies to ensure better dental care access for immigrant patients.

Key words: oral health, immigrants, dental care utilization, Chengdu

中图分类号:

陈稳, 张笑涵, Shannon H Houser, 周学东, 瞿星. 成都市外国人口腔卫生服务利用的影响因素研究[J]. 华西口腔医学杂志, 2018, 36(4): 428-434.

Wen Chen, Xiaohan Zhang, H Houser Shannon, Xue-dong Zhou, Xing Qu. Dental care utilization of immigrants in Chengdu, China[J]. West China Journal of Stomatology, 2018, 36(4): 428-434.

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调查项目	因变量	变量值	n/%
性别	男	0	433/66.2
	女	1	221/33.8
年龄/岁	12~20	0	65/9.9
	21~30	1	390/59.6
	31~40	2	116/17.7
	>40	3	83/12.7
教育程度	高中以下	0	41/6.3
	高中	1	126/19.3
	大学	2	325/49.7
	大学以上	3	162/24.8
年收入/美元	低于20 000	0	440/67.3
	20 000~40 000（含20 000）	1	99/15.1
	40 000~60 000（含40 000）	2	62/9.5
	60 000及以上	3	53/8.1
母国发展水平	发展中国家	0	347/53.1
	发达国家	1	307/46.9
在成都居住时间	月	连续性变量	-
是否与家人一起住在成都	否	0	493/75.4
	是	1	161/24.6
过去1年是否出现过口腔问题	否	0	479/73.2
	是	1	175/26.8
是否因口腔问题就诊	否	0	102/58.3*
	是	1	73/41.7*
刷牙频率	每天1次	0	183/28.0
	每天2次或2次以上	1	471/72.0
是否使用牙线	否	0	439/67.1
	是	1	215/32.9
是否定期洁牙	否	0	364/55.7
	是	1	290/44.3
是否有口腔保险	无	0	479/73.2
	有	1	175/26.8

调查项目	B	SE	Wald	df	P值	95%CI
常数	-5.592	0.649	74.314	1	<0.001**
性别	1.147	0.427	7.205	1	0.007**	1.363~7.282
年龄	0.279	0.230	1.469	1	0.226	0.842~2.076
教育程度	0.298	0.262	1.295	1	0.255	0.806~2.251
年收入	0.326	0.395	0.682	1	0.409	0.333~1.564
母国发展水平	0.016	0.384	0.002	1	0.966	0.463~2.088
在成都居住时间	0.025	0.005	22.774	1	<0.001**	1.015~1.036
是否与家人一起住在成都	0.699	0.348	4.038	1	0.044*	1.017~3.980
过去1年内是否出现过口腔问题	1.443	0.334	18.667	1	<0.001**	2.200~8.145
刷牙频率	0.095	0.391	0.059	1	0.809	0.423~1.957
是否使用牙线	1.248	0.367	11.567	1	0.001**	1.697~7.153
是否定期洁牙	0.277	0.359	0.593	1	0.441	0.375~1.534
是否有口腔保险	-0.487	0.443	1.209	1	0.272	0.258~1.464

组别	就医人数	未就医人数	合计
长期居住	50	309	359
短期居住	3	292	295
合计	53	601	654

因素	长期居住组	短期居住组
性别	0.010*	0.993
年龄	<0.001**	0.894
教育程度	0.037*	0.900
年收入	0.252	0.254
母国发展水平	0.008**	0.575
在成都居住时间	<0.001**	0.509
是否与家人一起住在成都	0.003**	0.422
1年内是否出现过口腔问题	<0.001**	0.079
刷牙频率	0.753	0.841
是否使用牙线	<0.001**	0.184
是否定期洁牙	0.973	0.624
是否有口腔保险	0.156	0.905

因素	B	SE	Wald	df	P值	95%CI
常量	-4.810	0.681	49.886	1	<0.001**
性别	1.070	0.451	5.639	1	0.018*	1.205~7.049
年龄	0.619	0.238	6.774	1	0.009**	1.165~2.962
教育程度	0.056	0.277	0.042	1	0.838	0.615~1.820
年收入	-0.337	0.402	0.702	1	0.402	0.325~1.570
母国发展水平	0.171	0.403	0.180	1	0.671	0.539~2.612
是否与家人一起住在成都	0.699	0.353	3.911	1	0.048*	1.006~4.019
过去1年内是否出现过口腔问题	1.509	0.355	18.029	1	<0.001**	2.254~9.078
刷牙频率	0.062	0.412	0.023	1	0.880	0.474~2.387
是否使用牙线	1.188	0.385	9.536	1	0.002**	1.544~6.977
是否定期洁牙	-0.251	0.376	0.448	1	0.503	0.372~1.624
是否有口腔保险	-0.512	0.467	1.202	1	0.273	0.240~1.496

成都市外国人口腔卫生服务利用的影响因素研究

Dental care utilization of immigrants in Chengdu, China

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