scholarly journals Modeling the Impact of COVID-19 on Dental Insurance Coverage and Utilization

2020 ◽  
Vol 100 (1) ◽  
pp. 50-57
Author(s):  
S.E. Choi ◽  
L. Simon ◽  
C.A. Riedy ◽  
J.R. Barrow
Keyword(s):  
United States ◽  
Dental Care ◽  
Insurance Coverage ◽  
The United States ◽  
Sensitivity Analyses ◽  
Dental Insurance ◽  
Unemployment Rates ◽  
Access To Dental Care ◽  
Ed Visits ◽  
The Impact

Unemployment rates in the United States are rapidly increasing as a result of the COVID-19 pandemic and attendant economic disruption. As employees lose their jobs, many will lose their employer-sponsored dental insurance (ESDI). Changes in insurance coverage are directly related to the oral health of the population, with many at risk of losing access to dental care. We assessed the impact of recent unemployment rates on insurance coverage and dental utilization. We estimated changes in dental insurance coverage at the state level, using previously applied econometric estimates. Expected changes in types of dental procedures performed at dental practices nationwide were assessed using a microsimulation model, using national practice survey data. Changes in emergency department (ED) visits for dental problems were estimated by fitting trendlines to ED visit patterns by payer type. Sensitivity analyses were conducted to assess how variations in unemployment rates and rates of ESDI in response to unemployment could alter the results. Since March 2020, the national unemployment rate has increased by 8.40 percentage points, an increase expected to result in more than 16 million individuals losing ESDI in the United States. Of these individuals, 45.0% are likely to enroll in their state’s Medicaid and Children’s Health Insurance Program, and 47.0% are expected to become uninsured. With these expected changes in dental insurance coverage, the average dental practice would experience decreases in routine checkup visits but increases in tooth extraction, a procedure that is highly used by publicly insured or uninsured patients. In addition, dental-related ED visits would be expected to grow by 4.0%. Losses of employment caused by the COVID-19 in the United States can have countervailing effects on people’s health by impeding access to dental care. Lack of dental insurance is expected to be more pronounced in states that have not expanded Medicaid or do not provide Medicaid dental benefits for adults.

scholarly journals Impact of the first COVID-19 shelter-in-place order in the United States on emergency department utilization, Marin County, California

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Large Scale ◽  
Temporal Dynamics ◽  
The United States ◽  
Emergency Department Utilization ◽  
Marin County ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.

Sociodemographic Characteristics of Mission of Mercy Attendees in Wisconsin

2019 ◽  
Vol 5 (2) ◽  
pp. 127-132
Author(s):  
C. Okunseri ◽  
E. Eggert ◽  
C. Zheng ◽  
F. Eichmiller ◽  
E. Okunseri ◽  
...  
Keyword(s):  
Dental Care ◽  
Dental Health ◽  
The United States ◽  
County Level ◽  
Chi Square ◽  
Access To Dental Care ◽  
Event Location ◽  
Chi Square Test ◽  
Population Ratio ◽  
The Impact

Objective: Mission of Mercy (MoM) events are scheduled to provide care to populations suffering from urgent needs and inadequate access to dental care in the United States. This study examined individual and county-level characteristics of MoM attendees and the factors associated with changes in the rate of attendance. Methods: Deidentified archival data for MoM events available from the America’s Dentists Care Foundation (2013–2016) were analyzed. Summary statistics were calculated separately for each year. Chi-square test was performed to identify changes in attendance distribution over time. Poisson regression analyses were conducted to test changes in the rate of attendance with and without adjustment for county-level characteristics and history of prior MoM events. Results: Total numbers of attendees at Wisconsin MoM events were 1,560, 1,635, 1,187, and 951 in 2013, 2014, 2015, and 2016, respectively. Attendees were mostly female (>50%) and White (58%–81%), and mean age ranged between 36.5 and 39.2 y. The average travel distance ranged between 27 and 80 miles. Residents of counties where MoM events were held in previous years were more likely to attend another MoM event after adjusting for county distance to current location. After adjusting for dentists-to-population ratio, event history, and county distance to event location, we found that there was no statistically significant change in the rate of attendance from 2013 to 2016. Conclusions: Previous attendees with experience of attending a MoM event in their counties of residence were more likely to attend another MoM event. Higher rates of attendance were associated with shorter travel distances to MoM events. Knowledge Transfer Statement: The Mission of Mercy (MoM) events are promoted by local dental organizations to highlight the issue of access to dental care and bring greater awareness to the problem by providing urgent dental care to populations in need. Through the data-sharing practices and analyses, policy makers, dental health advocates, and program organizers will have a better understanding of the impact and reach of the program. Findings from this study will help to expand program practices, promote efficiency, and aid in the identification of appropriate event locations, innovative strategies, and public policies relevant to addressing access to dental care.

Access to Dental Care Among Older Adults in the United States

2005 ◽  
Vol 69 (9) ◽  
pp. 961-974 ◽  
Author(s):  
Teresa A. Dolan ◽  
Kathryn Atchison ◽  
Tri N. Huynh
Keyword(s):  
United States ◽  
Older Adults ◽  
Dental Care ◽  
The United States ◽  
Access To Dental Care

Continued Evidence of the Impact of Rotavirus Vaccine in Children Less Than 3 Years of Age From the United States New Vaccine Surveillance Network: A Multisite Active Surveillance Program, 2006–2016

2020 ◽  
Author(s):  
Mary Allen Staat ◽  
Daniel C Payne ◽  
Natasha Halasa ◽  
Geoffrey A Weinberg ◽  
Stephanie Donauer ◽  
...  
Keyword(s):  
United States ◽  
Disease Burden ◽  
The United States ◽  
Population Based ◽  
Surveillance Program ◽  
Surveillance Network ◽  
Rotavirus Vaccination ◽  
Ed Visits ◽  
The Impact ◽  
Vaccine Surveillance

Abstract Background Since 2006, the New Vaccine Surveillance Network has conducted active, population-based surveillance for acute gastroenteritis (AGE) hospitalizations and emergency department (ED) visits in 3 United States counties. Trends in the epidemiology and disease burden of rotavirus hospitalizations and ED visits were examined from 2006 to 2016. Methods Children < 3 years of age hospitalized or visiting the ED with AGE were enrolled from January 2006 through June 2016. Bulk stool specimens were collected and tested for rotavirus. Rotavirus-associated hospitalization and ED visit rates were calculated annually with 2006–2007 defined as the prevaccine period and 2008–2016 as the postvaccine period. Rotavirus genotype trends were compared over time. Results Over 11 seasons, 6954 children with AGE were enrolled and submitted a stool specimen (2187 hospitalized and 4767 in the ED). Comparing pre- and postvaccine periods, the proportion of children with rotavirus dramatically declined for hospitalization (49% vs 10%) and ED visits (49% vs 8%). In the postvaccine era, a biennial pattern of rotavirus rates was observed, with a trend toward an older median age. G1P[8] (63%) was the predominant genotype in the prevaccine period with a significantly lower proportion (7%) in the postvaccine period (P < .001). G2P[4] remained stable (8% to 14%) in both periods, whereas G3P[8] and G12P[8] increased in proportion from pre- to postvaccine periods (1% to 25% and 17% to 40%), respectively. Conclusions The epidemiology and disease burden of rotavirus has been altered by rotavirus vaccination with a biennial disease pattern, sustained low rates of rotavirus in children < 3 years of age, and a shift in the residual genotypes from G1P[8] to other genotypes.

scholarly journals Positive impact of facility-based isolation of mild COVID-19 cases on effectively curbing the pandemic: a mathematical modelling study

2020 ◽  
Author(s):  
Simiao Chen ◽  
Qiushi Chen ◽  
Juntao Yang ◽  
Lin Lin ◽  
Linye Li ◽  
...  
Keyword(s):  
United States ◽  
Positive Impact ◽  
High Capacity ◽  
The United States ◽  
Sensitivity Analyses ◽  
Effective Capacity ◽  
Home Based ◽  
Primary Model ◽  
The Impact ◽  
At Home

Abstract Background In many countries, patients with mild coronavirus disease 2019 (COVID-19) are told to self-isolate at home, but imperfect compliance and shared living space with uninfected people limit the effectiveness of home-based isolation. We aim to examine the impact of facility-based isolation compared to self-isolation at home on the continuing epidemic in the United States. Methods We developed a compartment model to simulate the dynamic transmission of COVID-19 and calibrated it to key epidemic measures in the United States from March to September. We simulated facility-based isolation strategies with various capacities and starting times under different diagnosis rates. The primary model outcomes included the reduction of new infections and deaths over two months from October onwards. We further explored different effects of facility-based isolation under different epidemic burdens by major US Census Regions, and performed sensitivity analyses by varying key model assumptions and parameters. Results We projected that facility-based isolation with moderate capacity of 5 beds per 10 000 total population could avert 4.17 (95% Credible Interval 1.65–7.11) million new infections and 16 000 (8000-23 000) deaths in two months compared with home-based isolation, equivalent to relative reductions of 57% (44–61%) in new infections and 37% (27–40%) in deaths. Facility-based isolation with high capacity of 10 beds per 10 000 population would achieve greater reduction of 76% (62–84%) in new infections and 52% (37–64%) in deaths when supported by the expanded testing with a 20% daily diagnosis rate. Delays in implementation would substantially reduce the impact of facility-based isolation. The effective capacity and the impact of facility-based isolation varied by epidemic stage across regions. Conclusion Timely facility-based isolation for mild COVID-19 cases could substantially reduce the number of new infections and effectively curb the continuing epidemic compared to home-based isolation. The local epidemic burden should determine the effective scale of facility-based isolation strategies.

scholarly journals The impact of the Patient Protection and Affordable Care Act on insurance coverage and cancer‐directed treatment in HIV‐infected patients with cancer in the United States

Cancer ◽  
2019 ◽  
Vol 126 (3) ◽  
pp. 559-566 ◽  
Author(s):  
Kelsey L. Corrigan ◽  
Leticia Nogueira ◽  
K. Robin Yabroff ◽  
Chun Chieh Lin ◽  
Xuesong Han ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
The United States ◽  
Patients With Cancer ◽  
Patient Protection ◽  
The Impact

scholarly journals The Clinical Impact and Cost-effectiveness of Measles-Mumps-Rubella Vaccination to Prevent Measles Importations Among International Travelers From the United States

2018 ◽  
Vol 69 (2) ◽  
pp. 306-315 ◽  
Author(s):  
Emily P Hyle ◽  
Naomi F Fields ◽  
Amy Parker Fiebelkorn ◽  
Allison Taylor Walker ◽  
Paul Gastañaduy ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Hot Spots ◽  
Cost Effective ◽  
The United States ◽  
Clinical Impact ◽  
Sensitivity Analyses ◽  
Best Value ◽  
Measles Outbreaks ◽  
The Impact

Abstract Background Measles importations and the subsequent spread from US travelers returning from abroad are responsible for most measles cases in the United States. Increasing measles-mumps-rubella (MMR) vaccination among departing US travelers could reduce the clinical impact and costs of measles in the United States. Methods We designed a decision tree to evaluate MMR vaccination at a pretravel health encounter (PHE), compared with no encounter. We derived input parameters from Global TravEpiNet data and literature. We quantified Riskexposure to measles while traveling and the average number of US-acquired cases and contacts due to a measles importation. In sensitivity analyses, we examined the impact of destination-specific Riskexposure, including hot spots with active measles outbreaks; the percentage of previously-unvaccinated travelers; and the percentage of travelers returning to US communities with heterogeneous MMR coverage. Results The no-encounter strategy projected 22 imported and 66 US-acquired measles cases, costing $14.8M per 10M travelers. The PHE strategy projected 15 imported and 35 US-acquired cases at $190.3M per 10M travelers. PHE was not cost effective for all international travelers (incremental cost-effectiveness ratio [ICER] $4.6M/measles case averted), but offered better value (ICER <$100 000/measles case averted) or was even cost saving for travelers to hot spots, especially if travelers were previously unvaccinated or returning to US communities with heterogeneous MMR coverage. Conclusions PHEs that improve MMR vaccination among US international travelers could reduce measles cases, but are costly. The best value is for travelers with a high likelihood of measles exposure, especially if the travelers are previously unvaccinated or will return to US communities with heterogeneous MMR coverage.

scholarly journals A national study of the association between language use and health insurance coverage in the United States

2013 ◽  
Vol 2 (2) ◽  
pp. 115
Author(s):  
Garth Nigel Graham ◽  
Rashida Dorsey
Keyword(s):  
United States ◽  
Health Insurance ◽  
Ethnic Groups ◽  
Language Use ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
National Study ◽  
The Impact ◽  
The U.S

Background: A significant proportion of individuals seen in US hospitals speak a language other than English. A number of reports have shown that individuals who speak a language other than English have diminished access to care, but few have examined specifically language barriers and its relationship to health insurance coverage. Objectives: To estimate the impact of language use on prevalence of reported health insurance coverage across multiple racial and ethnic groups and among persons living in the U.S. for varying periods of time. Design and participants: Cross sectional study using data from the 2010 National Health Interview Survey. Main measures: The main outcome measure is health insurance status. Key results: Persons who spoke Spanish or a language other than English were less likely to have insurance. Among Hispanics who speak Spanish or a language other than English, only 50.6% report having health insurance coverage compared to 76.7% of Hispanics who speak only or mostly English. For non-Hispanic whites who speak Spanish or a language other than English, 71.7% report having health insurance coverage compared to 83.4% of non-Hispanic whites who speak only or mostly English, this same pattern was observed across all racial/ethnic groups. Among those speaking only or mostly English living in the U.S. <15 years had significantly lower adjusted odds of reporting health insurance coverage compared to those born in the United States. Conclusions: This was a large nationally representative study describing language differences in insurance access using a multi-ethnic population. This data suggest that individuals who speak a language other than English are less likely to have insurance across all racial and ethnic groups and nativity and years in the United States groups, underscoring the significant independent importance of language as a predictor for access to insurance.

scholarly journals Assessing the Oral Health Needs of African American Men in Low-Income, Urban Communities

2016 ◽  
Vol 12 (2) ◽  
pp. 326-337 ◽  
Author(s):  
Tabia Henry Akintobi ◽  
LaShawn M. Hoffman ◽  
Calvin McAllister ◽  
Lisa Goodin ◽  
Natalie D. Hernandez ◽  
...  
Keyword(s):  
Oral Health ◽  
Confidence Interval ◽  
Black Men ◽  
Low Income ◽  
Dental Care ◽  
Odds Ratio ◽  
The United States ◽  
Dental Insurance ◽  
Community Based ◽  
The Impact

Despite improvements in oral health status in the United States, pronounced racial/ethnic disparities exist. Black men are less likely to visit the dentist, are twice as likely to experience tooth decay, and have a significantly lower 5-year oral cancer survival rate when compared to White men. The Minority Men’s Oral Health Dental Access Program employed a community-based participatory research approach to examine the oral health barriers and opportunities for intervention among Black men in a low-income, urban neighborhood. A cross-sectional study design was implemented through a self-administered survey completed among 154 Black males. The majority reported not having dental insurance (68.8%). Most frequently cited oral health care barriers were lack of dental insurance and not being able to afford dental care. Attitudes related to the significance of dental care centered on cancer prevention and feeling comfortable with one’s smile. The impact of oral health on daily life centered on social interaction, with men citing insecurities associated with eating, talking, and smiling due to embarrassment with how their teeth/mouth looked to others. Multivariate logistic regression revealed that those who had difficulty finding dental care were 4.81 times (odds ratio = 4.65, 95% confidence interval [1.80, 12.85]) more likely to report no dental insurance, and 2.73 times (odds ratio = 3.72; 95% confidence interval [1.12, 6.70]) more likely to report poor oral health. Community-based participatory approaches include assessment of neighborhood residents affected by the health issue to frame interventions that resonate and are more effective. Social, physical, and infrastructural factors may emerge, requiring a multilevel approach.

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