Анализ демографических показателей и распространенности стоматологической заболеваемости у бездомных в условиях крупного мегаполиса

Проблема социального благополучия и состояния здоровья незащищенных слоев населения является малоисследованной темой в России. На данный момент оказание медицинской помощи лицам без определенного места жительства организовано в двух городах-миллионниках. Целью исследования был анализ и оценка демографических показателей, показателей распространенности стоматологической заболеваемости и изучение видов медицинской помощи, оказанной лицам без определенного места жительства, обратившихся за медицинской помощью в Первую благотворительную клинику для нуждающихся людей: АНО «Другая медицина», г. Челябинск, в 2022 и 2023 годах. Проведен ретроспективный статистический анализ медицинских амбулаторных карт бездомных пациентов. За 2 года в общей сложности в клинику обратились 393 пациента. Средний возраст составил 46 лет (S=36,6). Стоматологические проблемы стали поводом к первичному обращению у 40,4% (n=167) пациентов. Все остальные пациенты первично обратились за хирургической или терапевтической помощью, после чего они в плановом порядке были направлены на профилактический осмотр к врачу-стоматологу. Выявлено, что наиболее частой причиной обращения за стоматологической помощью стал хронический периодонтит, его обострения и осложнения. Ретроспективный анализ данных выявил положительную динамику частоты обращений в клинику. Вопрос организации стоматологической медицинской помощи бездомным нуждается в более глубоком изучении и учете медицинских, социально-экономических, психолого-поведенческих и других факторов, влияющих на обращаемость данной группы населения за медицинской помощью.

The problem of social well-being and health status of vulnerable groups of the population is an understudied topic in Russia. Currently, the provision of medical care to homeless people is organized in two cities with a population of over one million. The aim of the study was to analyze and evaluate demographic indicators, prevalence rates of dental diseases and study the types of medical care provided to homeless people who sought medical care at the First Charity Clinic for People in Need: ANO «Another Medicine», Chelyabinsk in 2022 and 2023. A retrospective statistical analysis of outpatient medical records of homeless patients was conducted. Over 2 years, a total of 393 patients sought medical care at the clinic. The average age was 46 (S=36.6). Dental problems were the reason for the initial visit in 40.4% (n=167) of patients. All other patients initially sought surgical or therapeutic care, after which they were routinely referred to a dentist for a preventive examination. It was found that the most common reason for seeking dental care was chronic periodontitis, its exacerbations and complications. Retrospective data analysis revealed positive dynamics in the frequency of visits to the clinic. The issue of organizing dental care for the homeless requires a more in-depth study and consideration of medical, socio-economic, psychological-behavioral and other factors affecting the appeal of this group of the population for medical care.

бездомные, стоматологическая заболеваемость, социальное благополучие, демографические показатели, медицинская помощь.

homeless, dental morbidity, social well-being, demographic indicators, medical care.

1. Киселева А., Гробман Е. Исследование: доля бездомных среди умирающих в крупных городах составила 4,4%. (Электронный ресурс). URL: https://www.vedomosti.ru/society/articles/2023/12/01/1008825-issledovanie-dolya-bezdomnih-sredi-umirayuschih-v-krupnih-gorodah-sostavila-44 (дата обращения: 15.11.2024).
2. Bretherton J. Reconsidering Gender in Homelessness. European Journal of Homelessness. 2017;11(1):1-22.
3. Choi S.E., Mo E., Sima C. et al. Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States. JDR clinical and translational research. 2024;9(3): 256-264. doi:10.1177/23800844231165016.
4. Gьven E., Birsen A. The Level of Fear Experienced by the Individuals and their Applications to Health Institutions during the Covid-19 Pandemic. Omega. 2023;87(2):649-664. doi:10.1177/00302228221103105.
5. Johnson V., Brondani M., Bergmann H. et al. Dental Service and Resource Needs during COVID-19 among Underserved Populations. JDR clinical and translational research. 2022;7(3):315-325. doi:10.1177/23800844221083965.
6. Kalenderian E., Spallek H., Franklin A. et al. COVID-19
and Dentistry: Challenges and Opportunities for Providing Safe Care. (Electronic resource). URL: https://psnet.ahrq.gov/primer/covid-19-and-dentistry-challenges-and-opportunities-providing-safe-care (access date: 15.11.2024).
7. Montgomery A.E., Szymkowiak D., Culhane D. Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness. Women's health issues: official publication of the Jacobs Institute of Women's Health. 2017;27(3): 256-263. doi:10.1016/j.whi.2017.03.014.
8. Moses J., Janosko J. Demographic Data Project: Gender and Individual Homelessness. (Electronic resource). URL: https://endhomelessness.org/demographic-data-project-gender-and-individual-homelessness/ (access date: 15.11.2024).
9. Rodriguez N.M., Lahey A.M., MacNeill J.J. et al. Homelessness during COVID-19: challenges, responses, and lessons learned from homeless service providers in Tippecanoe County, Indiana. BMC Public Health. 2021; 21:1657. doi:10.1186/s12889-021-11687-8.

REFERENCES:
1. Kiseleva A., Grobman E. Study: Homelessness among dying people in major cities was 4.4%. (Electronic resource). URL: https://www.vedomosti.ru/society/articles/2023/12/01/1008825-issledovanie-dolya-bezdomnih-sredi-umirayuschih-v-krupnih-gorodah-sostavila-44 (access date: 15.11.2024) (in Russ.).
2. Bretherton J. Reconsidering Gender in Homelessness. European Journal of Homelessness. 2017;11(1):1-22.
3. Choi S.E., Mo E., Sima C. et al. Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States. JDR clinical and translational research. 2024;9(3): 256-264. doi:10.1177/23800844231165016.
4. Gьven E., Birsen A. The Level of Fear Experienced by the Individuals and their Applications to Health Institutions during the Covid-19 Pandemic. Omega. 2023;87(2):649-664. doi:10.1177/00302228221103105.
5. Johnson V., Brondani M., Bergmann H. et al. Dental Service and Resource Needs during COVID-19 among Underserved Populations. JDR clinical and translational research. 2022;7(3):315-325. doi:10.1177/23800844221083965.
6. Kalenderian E., Spallek H., Franklin A. et al. COVID-19 and Dentistry: Challenges and Opportunities for Providing Safe Care. (Electronic resource). URL: https://psnet.ahrq.gov/primer/covid-19-and-dentistry-challenges-and-opportunities-providing-safe-care (access date: 15.11.2024).
7. Montgomery A.E., Szymkowiak D., Culhane D. Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness. Women's health issues: official publication of the Jacobs Institute of Women's Health. 2017;27(3): 256-263. doi:10.1016/j.whi.2017.03.014.
8. Moses J., Janosko J. Demographic Data Project: Gender and Individual Homelessness. (Electronic resource). URL: https://endhomelessness.org/demographic-data-project-gender-and-individual-homelessness/ (access date: 15.11.2024).
9. Rodriguez N.M., Lahey A.M., MacNeill J.J. et al. Homelessness during COVID-19: challenges, responses, and lessons learned from homeless service providers in Tippecanoe County, Indiana. BMC Public Health. 2021; 21:1657. doi:10.1186/s12889-021-11687-8.