Deprivation, demography and missed scheduled appointments at an NHS primary dental care and training service.,British Dental Journal

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Deprivation, demography and missed scheduled appointments at an NHS primary dental care and training service.
British Dental Journal ( IF 2.0 ) Pub Date : 2020-01-01 , DOI: 10.1038/s41415-020-1197-3
Amelia West ₁ , Tara Stones ₂ , Kristina Wanyonyi ₃

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Background Patients often do not attend planned routine dental appointments. This leads to unmet dental needs, under-utilisation of dental services, lost revenue for dental practice owners and lost educational opportunities when this occurs in centres of training. The aim of this project was to use electronic dental health records to investigate the factors associated with failing to attend dental appointments in an NHS primary dental care service provided free at the point of delivery.Method Electronic patient data over a one-year period were extracted. Data included: patients' age, sex, deprivation status and whether they missed at least one appointment. Deprivation status was derived from patients' postcodes converted to the indices of multiple deprivation quintiles (IMD). Data were analysed descriptively and analytically. Chi square tests were used to identify statistically significant associations (p <0.05) between patient characteristics and a record of a missed dental appointment. Logistic regression was used to model the patient-related factors which predict failure to attend scheduled appointments while controlling for confounding factors.Results A total of 3,678 patients aged between 2 and 98 years had at least one appointment offered within the 12-month period studied. Of these, 627 (17%) had at least one instance of 'Did Not Attend' ('DNA') on record. The age group with the highest proportion of patients with a 'DNA' were the 6-12 year olds (23.6%), and the lowest proportion were the >75 years olds (10.4%). A higher proportion of patients had a 'DNA' in the two most deprived quintiles (IMD Quintile 1-32.4% and IMD Quintile 2-33.3%), when compared with the least deprived quintile (IMD Quintile 5-6.5%). Logistic regression showed that males were 20% more likely to have a 'DNA' than females, the most deprived were twice more likely to have a 'DNA' than least deprived (p <0.05) and younger patients were more likely to not have a 'DNA' on record.Conclusion Routinely collected electronic primary dental care records from individual patients who were representative of the full spectrum of age and social status, when analysed, revealed patterns that predicted missed appointments. These patterns were independently associated with patients' age, deprivation and sex. Understanding these patterns can influence how poor dental access is addressed, the effective delivery of comprehensive care, child safeguarding, patient outcomes and primary dental care practice financing.

中文翻译：

NHS初级牙科保健和培训服务处的剥夺，人口统计学和错过预定的约会。

背景患者通常不参加计划的常规牙科预约。当在培训中心发生这种情况时，会导致无法满足牙科需求，对牙科服务的利用不足，牙科诊所所有者的收入减少以及教育机会的损失。该项目的目的是使用电子牙齿健康记录来调查与交付时免费提供的NHS初级牙齿护理服务中未能参加牙科预约相关的因素。方法提取一年期间的电子患者数据。数据包括：患者的年龄，性别，剥夺状态以及是否错过了至少一次约会。剥夺状态来自患者的邮政编码，这些邮政编码转换为多个剥夺五分位数（IMD）的索引。对数据进行描述性和分析性分析。卡方检验用于确定患者特征与错过牙科预约记录之间的统计学显着相关性（p <0.05）。使用Logistic回归对与患者相关的因素进行建模，以预测未能按计划参加的约会，同时控制混杂因素。结果在研究的12个月内，共有3,678名年龄在2至98岁之间的患者至少接受了一次约会。其中，有627个（17％）记录了至少一个'Did Not Attend'（'DNA'）实例。带有“ DNA”的患者比例最高的年龄组是6-12岁（23.6％），最低的比例是> 75岁的患者（10.4％）。在两个最缺乏的五分位数中，有较高比例的患者具有“ DNA”（IMD Quintile 1-32。与最少剥夺的五分位数（IMD的五分位数5-6.5％）相比，则为4％，IMD的五分位数为2-33.3％。Logistic回归显示，男性患“ DNA”的可能性比女性高20％，最贫穷者的“ DNA”可能性是最不贫穷者的两倍（p <0.05），而年轻患者更容易患“ DNA”记录中的“ DNA”。结论在分析后，常规收集了代表整个年龄和社会地位的个体患者的常规电子初级牙科护理记录，揭示了预测错过约会的方式。这些模式与患者的年龄，剥夺和性别独立相关。了解这些模式会影响到如何解决牙科入路困难，有效提供全面护理，保护儿童，

更新日期：2020-01-24

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