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Factors of the difficulty on dental treatment of disabled people with special needs
Yoshihisa Katoh,Mutsuko Makiya,Sanae Hironaka,Jumpei Kubota,Yasuaki Kakinoki Asia association of Disability and Oral health 2019 대한장애인치과학회지 Vol.15 No.2
A survey conducted in the 2018 fiscal year reported in Japan, that the number of people with disabilities - i.e. the number of people who have special needs - was approximately 9.36 million (physically disabled: 4.36 million, intellectually disabled: 1.08 million, mentally disabled: 3.92 million).There are approximately 90,000 dentists working at general community-based clinics, but due to the difficulties associated with treating patients with disabilities, patients tend to become concentrated in specialized facilities such as dental centers for the disabled that are managed by university-affiliated dental hospitals, government administrative bureaus, and dental associations. The reason for this is the fact that it is difficult to treat patients with disabilities using the standard methods, special considerations are required, and a great deal of time and effort is required - so much so that it is difficult for general clinics to treat such patients. Therefore, here we report on our survey that investigated what factors contributed to the difficulties associated with the dental care of disabled people at general clinics in the course of actual clinical practice. We conducted a retrospective survey of the following data obtained from medical records and electronic medical charts. : Name of disability, chronological age, developmental age, sex, status related to entering the examination room, number of staff members required for examination, oral hygiene status, the time required for a single examination, and the amount of remuneration received from the National Health Insurance (NIH) system. The developmental test utilized was the Enjoji Analytical Development Test for Infants. In order to extract the factors that affect the number of people required for examinations from the above survey items, we conducted multivariate logistic regression analysis with the two groups of numbers of people required as the response variables. The items compared included name of disability, chronological age, developmental age, sex, acceptance of treatment, oral hygiene status, and the amount of time required for a single examination. The reason why it is difficult for general clinics to care for patients with disabilities is the fact the low developmental ages of such patients requires additional time and manpower. This suggests that one factor related to this issue is the assessment that in Japan the medical remuneration proved under the NIH system is insufficient.
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