| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學研究所碩士在職專班 === 91 === Abstract
Due to the increasing number of cases in asthma patients, the Bureau of National Health Insurance established an asthma disease management program in November, 2001. The aims of this management plan were to improve the quality of care and to make the best use of medical resources, and hence, to establish the sustainable management and care for asthma patients. It was also expected that through this program, the oral hygiene education and the ability of patients’ self care would be enhanced.
Oral health is closely linked to the health of the whole body. Due to the use of Beclomethasone spray, some literature indicated its direct impact on oral health of asthma patients. The asthma disease management program included regular medical follow-ups and oral health education. The purpose of this study was to investigate the related factors for the differences of the dental utilization between the participants and non-participants of the asthma disease management program.
We used the asthma patients listed in the data of Bureau of National Health Insurance Kao-Ping Branch (main diagnosis code: 493) from January to March, 2002. There are 122 persons and 28,210 persons in the participant and non-participant groups, respectively. To avoid the systematic effects due to sex and age distributions a 1:10 matched study was designed. There were 1220 non-participants randomly selected according to the sex and age of each subject in the program. The dental expense records were collected for the study subjects. There were 49 and 469, respectively, for program participants and non-participants who had non-zero dental expenses during January to December, 2001 and January to December, 2002. The statistical analyses methods included descriptive statistics, chi-square tests, t-tests and multiple linear regressions.
The results indicated that: (1) the dental care expenses of the participant group after intervention was higher than that before intervention, but the non-participant group did not show this tendency; (2) in terms of the dental disease and the items of making diagnosis and giving treatment, the times of having and treating periodontal disease in the participant group increased after intervention; and there was no difference in non-participant group; (3) as far as the related factors were concerned, the expenses of dental treatment varied greatly according to age and the condition of the dental disease. As the result, the asthma patients had paid more attention to the oral health after the intervention of the disease management program. This research results recommended that the Bureau of National Health Insurance should consider the indirect effects from dental problems, and include dental health as an index of the quality of medical treatment in order to reach the goal of the health care of the whole.
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