| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學研究所碩士在職專班 === 94 === Background: Based on the right of health care of the people and the obligation of medical service from the government, the study is conducted to understand the supply of dental manpower, the accessibility of dental care and the utilization of dental treatment in dental resource deficient area.
Objectives:
1.To evaluate the supply and utilization of dental services from 2002 to 2004 in the project of “Improving the Experimental Plan for Medical Practice and Medical Tour in Dental Treatment Resource Deficient Area”.
2.To understand the utilization of dental treatment by the proposers domiciled in “dental treatment resource deficient area “, defined by the Bureau of National Health Insurance Kao-Ping Branch.
3.To collect opinions from dentists going service on dental resource deficient area by phone survey.
Materials and Methods:
The study is an analysis of secondary data. There are 274,679 insurers domiciled in dental resource deficient areas. Data used to estimate the amount of persons seeking for dental treatment (practice group and tour group) and the expenses include ID number, towns of domiciled, gender, age, health insurance cards, medical orders and treatment details. Data analysis was performed by using descriptive statistics.
Results and suggestion︰
1.For utilization of dental treatment, the ratio of practice group to tour group in patient numbers and expenses was about 20:80 and 7:93. In 2004, the average visit of each dental patient was 1.3 in Kaohsiung county (KC), 1.8 in Pingtung county (PTC) and 1.8 in Penghu county (PHC). The declared daily growth rate of dental visit was 6% in practice group and 38.6% in tour group when compared to 2003. Although the patient numbers in tour group increased 92.1% in 2004, the average service day per dentist was -27.8% in growth rate. Most of the patients (80.7%) were between age of 5 and 14.
2.For utilization of dental care, the annual demand rate (total cases in deficient area/ total cases by these insurers) in 2002, 2003 and 2004 was 3.4%, 6.5% and 10.7% respectively. For accessibility of dental care in 2004, the ratio of insurer seeking for dental treatment is 18% in KC, 22% in PTC and 33% in PHC. The expense per dental patient was 1356 NTD in KC, 2051 in PTC and 1669 in PHC. All were exceeded the national average (1181) and average (923) of whole dental resource deficient areas. The expense per visit was 1015 in KC, 1162 in PTC and 941 in PHC. The filling materials used for caries was mainly amalgam in children and resin in adults.
3.Phone survey of dentist going service in theses areas shows that service for the people and reward for the society are their main purpose.
Discussion and Suggestion ：
The government is using methods similar to the United State government such as state-financed program and salary raise for increasing the supply of dental manpower and the dental accessibility in dental resource deficient areas. As a whole, the practice effect is not so satisfactory when compared to medical tour .The accessibility of dental treatment in KC and PTC was under but in PHC has nearly reached the national standard (33.47%). It was mostly by tour not by practice. The demand rate was only 3.4-10.7%. I suggest that the dental treatment service needs to be enhanced in order to reach reasonable balance between its amount and expenses.
Key word: Dental Treatment Resource Deficient Areas,
Utilization of Dental Treatment
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