Underscreening and undertreatment? Periodontal service provision in very old Germans
| Autor: | Jesus Gomez Rossi, Sebastian Paris, Adelheid Kuhlmey, Falk Schwendicke, Joachim Krois, Hendrik Meyer-Lückel, Aleksander Krasowski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Rural Population
medicine.medical_specialty Service provision Gerodontology Odds 03 medical and health sciences 0302 clinical medicine Periodontal screening index Germany medicine Dementia Humans Health services research Periodontology 030212 general & internal medicine 610 Medicine & health Dental Care Periodontitis General Dentistry Periodontal Diseases Aged Geriatrics Aged 80 and over business.industry 030206 dentistry Root planning medicine.disease Access Original Article business 600 Technik Medizin angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit Demography |
| Zdroj: | Clinical Oral Investigations |
| DOI: | 10.1007/s00784-020-03635-4 |
| Popis: | Objectives We aimed to assess periodontal services utilization in very old Germans. Methods A comprehensive sample of very old (≥ 75 years), insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed periodontal service provision, entailing (1) periodontal screening index (PSI), (2) periodontal status/treatment planning, (3) periodontal therapy (scaling and root planning with or without access surgery), (4) postoperative reevaluation, and (5) any of these four services groups. Association of utilization with (1) sex, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses, and (6) diagnoses-related groups was explored. Results 404.610 individuals were followed; 173,733 did not survive follow-up. The mean (SD) age was 81.9 (5.4) years. 29.4% (119,103 individuals) utilized any periodontal service, nearly all of them the PSI. Periodontal status/treatment planning, treatment provision, and reevaluation were provided to only a small fraction (1.54–1.57%, or 6224–6345) of individuals. The utilization of the PSI increased between 2012 and 2017; no such increase was observed for treatment-related services. Utilization decreased with age; those aged > 85 years received nearly no services at all. Decreases were more pronounced for treatment-related services. Utilization was lower in rural than urban areas, those with hardship status, and those severely ill (e.g., dementia, heart insufficiency). In multivariable analysis, a previous PSI measurement tripled the odds of receiving treatment-related services (OR: 3.2; 95% CI: 3.0-3.4). Conclusions Periodontal services utilization was low. Screening for periodontal disease significantly increased therapy provision. Social, demographic, regional, and general health aspects were associated with utilization. Clinical significance The utilization of periodontal services in the very old in Northeast Germany was low, and even screening was only performed in a minority of individuals. Policies to increase identification and management of periodontitis especially in the most vulnerable individuals are needed. |
| Databáze: | OpenAIRE |
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