Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States.

IF 2.2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE JDR Clinical & Translational Research Pub Date : 2024-07-01 Epub Date: 2023-04-21 DOI:10.1177/23800844231165016

S E Choi, E Mo, C Sima, H Wu, M Thakkar-Samtani, E P Tranby, J Frantsve-Hawley, J R Barrow

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Abstract

Purpose: We aim to understand the impact of the COVID-19 on health care utilization and oral health conditions of patients at federally qualified health centers (FQHCs), where patients are disproportionately low income, publicly insured, or uninsured.

Methods: Using deidentified electronic health records of patients at FQHCs in the United States from January 2019 through December 2020 (n = 431,509), variations in health care utilization since the COVID-19 outbreak were observed by procedure types and patient characteristics. Changes in dental utilization and oral health conditions were characterized using mixed-effect negative binomial and logistic regression models.

Results: Dental utilization decreased more drastically than medical utilization during shelter-in-place periods in 2020 and rebounded more slowly after the reopening. Greater demands for oral surgery and teledentistry and less demands for preventive services were observed in 2020. As compared to 2019, patients experienced more psychological stress-related dental conditions with odds ratios of 1.52 (95% confidence interval [CI], 1.31-1.76) for uninsured, 1.48 (95% CI, 1.07-2.02) for Medicaid enrollees, and 2.38 (95% CI, 1.68-3.40) for private insurance beneficiaries.

Conclusion: As a result of COVID-19, patients received more invasive dental procedures due to delayed treatment and experienced a higher risk of psychological stress-related dental conditions. Continued support for statewide policies to expand access to oral health care and oral health promotion strategies for the vulnerable populations would be encouraged.

Knowledge transfer statement: Our study describes the impact of COVID-19 on dental care use and oral health conditions at Federally Qualified Health Centers, targeted to provide care for some of the most vulnerable populations in the United States. The results of this retrospective cohort study can be used by clinicians and policymakers on understanding the clinical needs of the vulnerable populations after the pandemic. It highlights the need for continued support to expand access to oral health care and oral health promotion to these populations.

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COVID-19 对美国牙科保健使用率和口腔健康状况的影响。

目的：我们旨在了解 COVID-19 对联邦合格医疗中心 (FQHC) 患者的医疗利用率和口腔健康状况的影响，这些医疗中心的患者大多是低收入、公共保险或无保险者：利用美国联邦合格医疗中心患者在 2019 年 1 月至 2020 年 12 月期间的去身份化电子健康记录（n = 431,509 人），按手术类型和患者特征观察 COVID-19 爆发以来医疗利用率的变化。利用混合效应负二项式和逻辑回归模型对牙科利用率和口腔健康状况的变化进行了描述：结果：在 2020 年就地避难期间，牙科利用率的下降幅度比医疗利用率的下降幅度更大，而在重新开放后，牙科利用率的反弹速度则更慢。2020 年，口腔外科手术和远程牙科服务的需求增加，而预防服务的需求减少。与 2019 年相比，患者经历了更多与心理压力相关的牙科疾病，未参保者的几率比为 1.52（95% 置信区间 [CI]，1.31-1.76），医疗补助参保者的几率比为 1.48（95% CI，1.07-2.02），私人保险受益人的几率比为 2.38（95% CI，1.68-3.40）：结论：COVID-19 的结果是，由于治疗延迟，患者接受了更多的侵入性牙科治疗，并经历了更高的与心理压力相关的牙科疾病风险。我们鼓励在全州范围内继续支持扩大口腔医疗服务的政策以及针对弱势群体的口腔健康促进策略：我们的研究描述了 COVID-19 对联邦合格卫生中心的牙科保健使用和口腔健康状况的影响，这些中心主要为美国一些最弱势的人群提供保健服务。这项回顾性队列研究的结果可用于临床医生和政策制定者了解大流行后弱势群体的临床需求。它强调了继续支持扩大这些人群获得口腔保健和促进口腔健康的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JDR Clinical & Translational Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

6.20

自引率

6.70%

发文量

期刊介绍： JDR Clinical & Translational Research seeks to publish the highest quality research articles on clinical and translational research including all of the dental specialties and implantology. Examples include behavioral sciences, cariology, oral & pharyngeal cancer, disease diagnostics, evidence based health care delivery, human genetics, health services research, periodontal diseases, oral medicine, radiology, and pathology. The JDR Clinical & Translational Research expands on its research content by including high-impact health care and global oral health policy statements and systematic reviews of clinical concepts affecting clinical practice. Unique to the JDR Clinical & Translational Research are advances in clinical and translational medicine articles created to focus on research with an immediate potential to affect clinical therapy outcomes.