scholarly journals Do Oral Health Services in Medical Offices Replace Pediatric Dental Visits?

2020 ◽  
Vol 99 (8) ◽  
pp. 891-897 ◽  
Author(s):  
A.M. Kranz ◽  
R.G. Rozier ◽  
B.D. Stein ◽  
A.W. Dick
Keyword(s):  
Oral Health ◽  
Health Services ◽  
Young Children ◽  
Dental Care ◽  
Primary Care Providers ◽  
The United States ◽  
Dental Visit ◽  
Dental Visits ◽  
Oral Health Services ◽  
Linear Probability

In the United States, state Medicaid programs pay for medical and dental care for children from low-income families and support nondental primary care providers delivering preventive oral health services (POHS) to young children in medical offices (“medical POHS”). Despite the potential of these policies to expand access to care, there is concern that they may replace dental visits with medical POHS. Using Medicaid claims from 38 states from 2006 to 2014, we conducted a repeated cross-sectional study and used linear probability regression to estimate the association between the annual proportion of children in a county receiving medical POHS and the probability that a child received 1) dental POHS and 2) a dental visit in a given year. Models included county and year fixed effects and controlled for child- and county-level factors, and standard errors were clustered at the state level. In a weighted population of 45.1 million child-years (age, 6 mo to <6 y), we found no significant nor substantively important association between the proportion of children in a county receiving medical POHS and the probability that a child received dental POHS or a dental visit. Additionally, we found an almost zero probability (<0.001) that the reduction in dental POHS was at least as large as the expansion in medical POHS (full substitution) and a 0.50 probability that increased medical POHS was associated with an increase in dental POHS of at least 6.6% of the expansion of medical POHS. Results were similar when receipt of dental visits was examined. This study failed to find evidence that medical POHS replaced dental visits for young children enrolled in Medicaid and, in fact, offers evidence that increased medical POHS was associated with increased utilization of dental care. Given lower-than-desired rates of dental visits for this population, delivery of medical POHS should be expanded.

scholarly journals Dental visits in Medicaid-enrolled youth with mental illness: an analysis of administrative claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Erica L. Stockbridge ◽  
Eleena Dhakal ◽  
Stacey B. Griner ◽  
Abiah D. Loethen ◽  
Joseph F. West ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Oral Health ◽  
Dental Care ◽  
Service Use ◽  
Claims Data ◽  
The United States ◽  
Administrative Claims ◽  
Dental Visits ◽  
Administrative Claims Data

Abstract Background State Medicaid plans across the United States provide dental insurance coverage to millions of young persons with mental illness (MI), including those with attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder, and schizophrenia. There are significant oral health challenges associated with MI, and providing dental care to persons with MI while they are young provides a foundation for future oral health. However, little is known about the factors associated with the receipt of dental care in young Medicaid enrollees with MI. We aimed to identify mental and physical health and sociodemographic characteristics associated with dental visits among this population. Methods We retrospectively analyzed administrative claims data from a Medicaid specialty health plan (September 2014 to December 2015). All enrollees in the plan had MI and were ≥ 7 years of age; data for enrollees aged 7 to 20 years were analyzed. We used two-level, mixed effects regression models to explore the relationships between enrollee characteristics and dental visits during 2015. Results Of 6564 Medicaid-enrolled youth with MI, 29.0% (95% CI, 27.9, 30.1%) had one or more visits with a dentist or dental hygienist. Within youth with MI, neither anxiety (Adjusted odds ratio [AOR] = 1.15, p = 0.111), post-traumatic stress disorder (AOR = 1.31, p = 0.075), depression (AOR = 1.02, p = 0.831), bipolar disorder (AOR = 0.97, p = 0.759), nor schizophrenia (AOR = 0.83, p = 0.199) was associated with dental visits in adjusted analyses, although having ADHD was significantly associated with higher odds of dental visits relative to not having this condition (AOR = 1.34, p < 0.001). Age, sex, race/ethnicity, language, and education were also significantly associated with visits (p < 0.05 for all). Conclusions Dental utilization as measured by annual dental visits was lower in Medicaid-enrolled youth with MI relative to the general population of Medicaid-enrolled youth. However, utilization varied within the population of Medicaid-enrolled youth with MI, and we identified a number of characteristics significantly associated with the receipt of dental services. By identifying these variations in dental service use this study facilitates the development of targeted strategies to increase the use of dental care in – and consequently improve the current and long-term wellbeing of – the vulnerable population of Medicaid-enrolled youth with MI.

Implementation of Oral Health Screening and Referral Guidelines in Primary Health Care

2018 ◽  
Vol 4 (2) ◽  
pp. 167-177 ◽  
Author(s):  
Y. Zhu ◽  
K. Close ◽  
L.P. Zeldin ◽  
B.A. White ◽  
R.G. Rozier
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Health Services ◽  
American Academy ◽  
Dental Care ◽  
Health Screening ◽  
Referral Process ◽  
American Academy Of Pediatrics ◽  
Referral Practices ◽  
Oral Health Services

Objectives: To determine the oral health screening and referral practices of pediatric providers, their adherence to American Academy of Pediatrics oral health guidelines, and barriers to adherence. Methods: Providers in 10 pediatric practices participating in the North Carolina Quality Improvement Initiative, funded by the Child Health Insurance Program Reauthorization Act of 2009, were asked to complete a 91-item questionnaire. Questions on risk assessment and referral practices were based on those recommended by the American Academy of Pediatrics. Adherence to oral health guidelines was assessed by practitioners’ evaluation of 4 vignettes presenting screening results for an 18-mo-old child with different levels of risk and caries status. Respondents chose referral recommendations assuming adequate and inadequate dentist workforces. Logit models determined the association between barriers specified in Cabana’s framework and adherence (count of 6 to 8 adherent vignettes vs. 0 to 5). Results: Of 72 eligible providers, 53 (74%) responded. Almost everyone (98.1%) screened for dental problems; 45.2% referred in at least half of well-child visits. Respondents were aware of oral health guidelines, expressed strong agreement with them, and reported confidence in providing preventive oral health services. Yet they underreferred by an average of 42% per vignette for the 7 clinical vignette-workforce scenarios requiring an immediate referral. Frequently cited barriers were providers’ beliefs that 1) parents are poorly motivated to seek dental care, 2) oral health counseling has a small effect on parent behaviors, 3) there is a shortage of dentists in their community who will see infants and toddlers, and 4) information systems to support referrals are insufficient. Conclusion: Pediatric clinicians’ beliefs lead to a conscious decision not to refer many patients, even when children should be referred. Knowledge Transfer Statement: Evidence suggests that the primary care–dental referral process needs improvement. This study identifies barriers to delivering recommended preventive oral health services in pediatrics. The information can be used to improve the screening and referral process and, thus, the quality of preventive oral health services provided in primary care. Results also can guide researchers on the selection of interventions that need testing and might close gaps in the referral process and improve access to dental care.

scholarly journals Dental and Oral Problem Patterns and Treatment Seeking Behavior of Geriatric Population

2017 ◽  
Vol 11 (1) ◽  
pp. 230-236 ◽  
Author(s):  
Bader K. AlZarea
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Services ◽  
Dental Care ◽  
Elderly Persons ◽  
Health Seeking ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Dental Practitioners ◽  
Oral Health Services

Background:The manifestations of oral changes and disorders affecting the geriatric population are different from the rest of the population. Inaccessibility to dental care is a compelling impediment to avail oral health services.Objective:The aims were to assess the dental and oral problems and to find out the determinants of oral health seeking behaviour among elderly population of Al-Jouf province, Saudi Arabia.Methods:The present cross sectional study included geriatric patients of 60 years and above, who visited the College of Dentistry, Al-Jouf University. A simple pre-structured questionnaire was filled by the patients, which comprised of demographic details and the different oral complaints of elderly and the type of health care utilized for those complaints.Results:Out of total 892 elderly persons included, 51.79% were males and 48.21 were females. The most common oral problem was missing tooth (78.69%) followed by gum problems (74.21%). 39.5% males and 28.0% females visited general dental practitioners for oral health care. Majority of the participants (32.8%) suggested accessibility as a basic factor in determining the health care source. The difference in the distribution of male and females or association between the type of care and gender and distribution for choosing a health care source was found to be statistically significant (p< 0.05).Conclusion:Inaccessibility to dental care emerged as an important barrier to avail oral health services. Adequate access to medical and dental care can reduce premature morbidity and mortality, preserve function, and enhance overall quality of life.

scholarly journals Faktor yang Berhubungan dengan Pemanfaatan Pelayanan Kesehatan Gigi dan Mulut di Puskesmas Karanganyar Purbalingga Jawa Tengah: Studi tentang Faktor Pengetahuan, Pendidikan, Pekerjaan, Pendapatan, dan Aksesibilitas

e-GIGI ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 273
Author(s):  
Sindiawani G. Radiani ◽  
Oedijani Santoso ◽  
Yoghi B. Prabowo ◽  
Tira H. Skripsa
Keyword(s):  
Oral Health ◽  
Health Services ◽  
Dental Care ◽  
Care Utilization ◽  
Chi Square ◽  
Dental Care Utilization ◽  
Regression Test ◽  
Chi Square Test ◽  
Oral Health Services ◽  
Logistic Regression Test

Abstract: Utilization of dental and oral health services cover the health service and the usage of facilities. This study was aimed to determine and to analyze the relationship between knowledge, education, income, occupation, and accessibility of dental care utilization and oral health services at Karang- anyar health centers of Purbalingga. This was an analytical survey study with a cross sectional design. There were 185 respondents of the working area of Karanganyar health center selected by consecutive sampling. Data were collected by using a validated questionnaire. Data were analyzed by using chi-square test followed by logistic regression test. The results showed that there were 76.8% of respondents who used dental care and oral health services in the three last months before pandemic Covid-19; 35% of respondents had no work; 69.2% had low level of education; 81.21% had high level of knowledge; 83.2% had low income; and 85.1% clarified that the accessibility was not reachable. The chi-square test showed a significant correlation between levels of knowledge (p=0.02), income (p=0.04), education (p=0.012) and dental care utilization as well as oral health services. The logistic regression test showed that knowledge (OR=0.569 (95%CI:0.358-0.903) was the most dominant correlated to dental care utilization and oral health services. In conclusion, levels of knowledge, income, and education had significant relationships with dental care utilization and oral health services at Karanganyar health center.Keywords: knowledge; income; education; dental care utilization and oral health servicesAbstrak: Pemanfaatan pelayanan kesehatan gigi dan mulut mencakup pelayanan dan penggunaan fasilitas pelayanan kesehatan gigi dan mulut. Penelitian ini bertujuan untuk mengetahui dan menganalisis hubungan antara pengetahuan, pendapatan, pendidikan, pekerjaan, dan aksesibilitas terhadap pemanfaatan pelayanan kesehatan gigi dan mulut di Puskesmas Karanganyar Kabupaten Purbalingga. Jenis penelitian ialah survei analitik dengan desain potong lintang. Sampel penelitian ialah 185 masyarakat di wilayah kerja Puskesmas Karanganyar, dipilih secara consecutive sampling. Pengambilan data dilakukan dengan menggunakan kuisioner yang sudah divalidasi. Data dianalisis menggunakan uji chi-square dilanjutkan dengan uji regresi logistik. Hasil penelitian mendapatkan bahwa responden yang memanfaatkan pelayanan kesehatan gigi dan mulut tida bulan terakhir sebelum pandemi covid-19 sebanyak 76,8%; tidak bekerja 35%; pendidikan rendah 69,2%; tingkat pengetahuan tinggi 81,1%; pendapatan rendah 83,2%; dan 85.1% menyatakan aksesibilitas tidak terjangkau. Hasil uji chi-square menunjukkan hubungan bermakna antara tingkat pengetahuan (p=0,02), pendapatan (p=0,04), pendidikan (p=0,012) terhadap pemanfaatan pelayanan kesehatan gigi dan mulut. Hasil uji regresi logistik menunjukkan bahwa faktor pengetahuan OR=0,569 (95% CI:0,358-0,903) yang paling dominan berhubungan dengan pemanfaatan pelayanan kesehatan gigi dan mulut. Simpulan penelitian ini ialah tingkat pengetahuan, pendapatan, pendidikan memiliki hubungan bermakna dengan pemanfaatanpelayanan kesehatan gigi dan mulut di Puskesmas Karanganyar.Kata kunci: pengetahuan; pendapatan; pendidikan; pemanfaatan pelayanan kesehatan gigi dan mulut 

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