scholarly journals An Analysis of Electronic Primary Dental Practice Tooth Wear Referrals

2021 ◽  
Vol 10 (1) ◽  
pp. 56-62
Author(s):  
Zohaib Khwaja ◽  
Brian J. Millar
Keyword(s):  
Erosive Wear ◽  
Tooth Wear ◽  
Patient Demographics ◽  
Care Services ◽  
General Dental Practitioner ◽  
Clinical Photograph ◽  
Electronic Referral ◽  
Over 40 Years ◽  
Wear Index

We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex. Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed. Of 671 referrals, 32% were for TW. Males were referred more commonly (1.7:1.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p<0.001). Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p<0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p<0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p<0.001, respectively). There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).

TOOTH WEAR AND RELATED FACTORS IN PEOPLE OVER 18 YEARS OLD EXAMINED AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
Vol 8 (3) ◽  
pp. 42-47
Author(s):  
Tai Tran Tan ◽  
Huong Nguyen Ho Lan
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Alcohol Consumption ◽  
Key Words ◽  
Tooth Wear ◽  
Tooth Decay ◽  
Related Factors ◽  
The Mean ◽  
Wear Index

Background: Tooth wear leads to many bad consequences such as causing tooth sensitivity, affecting the vitality of the pulp, increasing the risk of tooth decay,… thus reducing the quality of life of the patient. The aims of this study were to investigate prevalence, degree of tooth wear according to Tooth Wear Index (TWI), and to determine related factors to tooth wear. Material and Methods: 298 patients over 18 years old had been examined at Hue Univesity of Medicine and Pharmacy Hospital from November 2016 to April 2017. All of them had stable overall and mental health and there were at least 20 teeth in the mouth. Tooth wear status and degree of tooth wear are evaluated according to TWI. Identifying related factors to tooth wear. Results: Prevalence of tooth wear was 67.1%, the mean tooth wear index was 0.34 ± 0.32. On average, each object had 12.11 worn sufaces. There was a relationship between tooth wear with age (p<0.05), male (p<0.05), improper brushing (p<0.05), using hard toothbrush (p<0.001), alcohol consumption (p<0.05), grinding habit (p<0.001). Conclusions: The prevalance of tooth wear is still quite high. We need to identify related factors for the consultation and prevention of tooth wear. Key words: Tooth wear, related factors

scholarly journals A Comparison of Etiology-Derived and Non-Etiology-Derived Indices Utilizing for Erosive Tooth Wear in People with Eating Disorders. The Validation of Economic Value in Clinical Settings

Coatings ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 471
Author(s):  
Irena Zalewska ◽  
Agata Trzcionka ◽  
Marta Tanasiewicz
Keyword(s):  
Eating Disorders ◽  
Economic Value ◽  
Erosive Wear ◽  
Tooth Wear ◽  
Dental Erosion ◽  
Diagnostic Tools ◽  
Control Group ◽  
Study Group ◽  
Medical Institutions ◽  
Wear Index

Increasing occurrence of non-carious lesions in their various forms and etiologies requires reliable and valid diagnostic tools to register their distribution, severity, and progression and to become helpful in planning treatment. The aim of this work is to evaluate eight selected (etiological and non-etiological) indices of tooth wear/erosion, taking into account the subjective opinion of the researcher/operator and the patients being treated for eating disorders. The research sample included 60 people with symptoms of dental erosion. The study group included 30 patients suffering from eating disorders, recruited from three independent medical institutions providing eating disorder therapy. The control group consisted of 30 patients with no eating disorders, but with dental erosion caused mostly by a low-pH diet. The indices chosen for evaluation were: Tooth Wear Index by Smith and Knight; indexes by Lussi, Johansson et al.; Tooth Wear Index modified by de Carvahlo Sales-Peres et al.; Linkosalo and Markkanen modified by Ganss et al.; and index Oilo et al., BEWE, VEDE. The examination took place during three short visits. The study group (suffering eating disorders) and the control group (without eating disorders) evaluated the indices chosen for this research similarly. In the assessment made by both groups of patients, the usefulness and application benefits of the etiological indices set were not significantly different than in the case of a set of non-etiological indexes. An analogous opinion has been made by the operator/researcher as far, as the following aspects are concerned: the number of indexes criteria, order of difficulty in memorizing criteria and in the procedure of indexes application. According to this research, for the group at risk of dental erosive wear (with or without eating disorders), optimal research tools to evaluate dental wear occurred: index by Lussi, Tooth Wear Index modified by de Carvahlo Sales-Peres et al., BEWE, index by Oilo et al.

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

Access to health care and Informal Patient Payments for health care in Serbia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Local Population ◽  
Civil Servants ◽  
Care Providers ◽  
Care Services ◽  
Access To Health

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.

scholarly journals Implementing an Integrated Large-Scale Clinical Information System for ISSSTE’s Hospital Network in Mexico

2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara
Keyword(s):  
Health Care ◽  
Information System ◽  
Health Care Services ◽  
Large Scale ◽  
Clinical Information System ◽  
Clinical Information ◽  
Public Hospitals ◽  
Care Services ◽  
Cost Reductions

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.

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