Journal of public health dentistry最新文献_第8页

Latino dentists in the U.S. Census from 1980 to 2019: Implications for dental care access 1980年至2019年美国人口普查中的拉丁裔牙医:对牙科护理获取的影响

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-01-18 DOI: 10.1111/jphd.12554

Paul Hsu MPH, PhD, David E. Hayes-Bautista PhD

Objectives

This study describes the supply of Latino dentists in the United States from 1980 to 2019, as tabulated by the Census. The number of Latino dentists per 100,000 Latino population was compared to the number of non-Hispanic White (NHW) dentists per 100,000 NHW population. These four-decade comparisons were made for the entire country as well as the five states having the largest Latino populations.

Methods

Data from the decennial census and the American Community Survey were used to identify the nationwide population, the number of dentists, and their respective Spanish-language abilities, stratified by race/ethnic group (Latinos and non-Hispanic Whites).

Results

In 1980, there were only 18 Latino dentists for every 100,000 Latino population in the entire nation, compared to 70 NHW dentists per 100,000 NHW population. While there was an increase to 21 Latino dentists per 100,000 in 1990, the supply remained virtually the same over this almost 40-year period, ending back at 18 per 100,000 in 2019. In comparison, there were about four times as many non-Hispanic White dentists as Latino dentists. This national discrepancy was also reflected in the five states that were evaluated. Similarly, Latino dentists were far more likely to speak Spanish than NHW dentists at both the national and state levels.

Conclusions

The Latino dentist supply, already inadequate in 1980, has remained virtually unchanged over the past almost 40 years. The authors believe that this deficiency will have profound consequences, and recommend that initiatives be undertaken to increase the number of Latino dentists.

目的本研究描述了1980年至2019年美国拉丁裔牙医的供应情况，如人口普查所示。将每100000名拉丁裔人口中的拉丁裔牙医人数与每100000名非西班牙裔白人（NHW）牙医人数进行了比较。这40年的比较是针对整个国家以及拉丁裔人口最多的五个州进行的。方法使用十年一次的人口普查和美国社区调查的数据，按种族/民族（拉丁裔和非西班牙裔白人）分层，确定全国人口、牙医人数及其各自的西班牙语能力。结果1980年，全国每10万拉丁裔人口中只有18名拉丁裔牙医，而每10万人口中有70名NHW牙医。虽然1990年每10万人中有21名拉丁裔牙医，但在这近40年的时间里，供应量几乎保持不变，2019年又回到了每10万名中有18名。相比之下，非西班牙裔白人牙医的数量大约是拉丁裔牙医的四倍。这种国家差异也反映在接受评估的五个州。同样，在国家和州一级，拉丁裔牙医比NHW牙医更有可能说西班牙语。结论拉丁裔牙医的供应在1980年就已经不足，在过去的近40年里几乎没有变化年。作者认为，这一缺陷将产生深远的影响，并建议采取措施增加拉丁裔牙医的数量。

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引用次数: 0

American Board of Dental Public Health diplomate survey, 2021: Competency domains and practice 美国牙科公共卫生委员会文凭调查，2021:能力领域和实践

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-12-13 DOI: 10.1111/jphd.12553

Mark D. Macek DDS, DrPH, Athanasios Zavras DMD, DDS, MS, DrMedSc, Scott L. Tomar DMD, MPH, DrPH, David Cappelli DMD, MPH, PhD, Susan McKernan DMD, MS, PhD, Peggy Timothe DDS, MPH, Christopher Okunseri BDS, MSc, MLS, DDPHRCSE, FFDRCSI

Objective

To describe current Dental Public Health diplomates and list the competency domains that diplomates considered either essential or optional elements of their practice.

Methods

The American Board of Dental Public Health administered an electronic survey to active and life member diplomates during September 2021. The survey included 101 items in three sections: (1) Education and Work Experience; (2) Dental Public Health Tasks; and (3) Demographics. The Dental Public Health Tasks section asked individuals how essential work-related tasks were to their current practice. Descriptive analyses were conducted using SAS.

Results

The overall response rate was 82.6% (157 eligible of 190 returned). Most respondents were women, 35 to 54 years of age, and either non-Hispanic white or non-Hispanic Asian. Twice as many had DDS or DMD degrees than BDS degrees. The vast majority completed a Dental Public Health residency and received masters level training from an accredited program. About three-fourths worked in the United States and held a U.S. license. More than 37% reported a second doctoral degree and 70% worked in academia. Responses to questions about tasks closely aligned with working in academia and less so with positions related to advocacy, regulation, and program evaluation.

Conclusions

Current diplomates are concentrated in academia. If this trend continues, it may be necessary to restructure the competencies, so training and skills acquisition remain timely and relevant. The specialty may also need to encourage future generations to consider non-academic positions so Dental Public Health remains an impactful component of the public health care system.

目的描述目前的牙科公共卫生外交官，并列出外交官认为其执业的基本或可选要素的能力领域。方法美国牙科公共卫生委员会在2021年9月对现役和终身外交官进行了一项电子调查。调查包括三个部分的101个项目：（1）教育和工作经验；（2）牙科公共卫生任务；（3）人口统计。牙科公共卫生任务部分询问个人与工作相关的任务对他们目前的实践有多重要。使用SAS进行描述性分析。结果总有效率为82.6%（190例患者中157例符合条件）。大多数受访者是35至54岁的女性年龄，以及非西班牙裔白人或非西班牙裔亚裔。具有DDS或DMD学位的人数是BDS学位的两倍。绝大多数人完成了牙科公共卫生实习，并接受了认证项目的硕士级培训。大约四分之三的人在美国工作并持有美国执照。超过37%的人获得了第二个博士学位，70%的人在学术界工作。对任务问题的回答与学术界的工作密切相关，而与倡导、监管和项目评估相关的职位则不太相关。结论目前的外交官主要集中在学术界。如果这种趋势持续下去，可能有必要调整能力结构，以便培训和技能获取仍然是及时和相关的。该专业可能还需要鼓励后代考虑非学术职位，以便牙科公共卫生仍然是公共卫生保健系统中有影响力的组成部分。

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引用次数: 0

Association between cash transfer programs and oral health—A scoping review 现金转移支付计划与口腔健康的关系——范围审查

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-12-02 DOI: 10.1111/jphd.12552

Beatriz Carriconde Colvara PhD, Ankur Singh PhD, Adyya Gupta PhD, Roger Keller Celeste PhD, Juliana Balbinot Hilgert PhD

Objectives

The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health; and to identify the theoretical frameworks applied to guide this literature.

Methods

A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted.

Results

Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association.

Conclusion

Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health.

本综述的目的是评估研究现金转移支付计划与口腔健康之间关系的文献;并确定用于指导本文献的理论框架。方法对一系列数据库应用检索策略，以确定2020年12月之前发表的研究。以现金转移计划作为暴露/干预和口腔健康为结果的观察性和干预性研究被考虑在内。牙科保健服务的利用以及获得牙科保健服务被视为次要结果。现金转移支付方案被认为是基于作为国家社会保护计划一部分的有条件或无条件现金转移支付的方案，关于现金转移支付对口腔健康影响的干预性研究也被认为是合格的。数据绘制分两步进行，并进行叙事综合。结果在鉴定的6344篇文章中，共纳入4篇。这些文章调查了三种不同的有条件现金转移计划，即普遍儿童津贴(阿根廷)、Bolsa Família(巴西)和家庭奖励(美国)。在有条件现金转移计划对龋齿患病率的影响的研究结果中发现了不一致之处，这些差异可能是由于为每项研究选择的对照组。至于看牙医，结果指向不同的方向，这使得这些发现仍然没有定论。文章中没有明确的理论框架来指导预期的关联。结论:尽管现金转移在改善某些健康结果方面发挥着重要作用，但表明现金转移与口腔健康之间存在关联的证据有限。

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引用次数: 1

Cost-effectiveness analysis of fissure sealants for caries prevention in children 预防儿童龋齿的裂隙封闭剂成本-效果分析

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-27 DOI: 10.1111/jphd.12549

Edibe Egil DDS, PhD, Emine Yaylali MSc, PhD

Objective

To evaluate the cost-effectiveness of resin-based and glass ionomer-based fissure sealants compared with no intervention for children.

Methods

We developed a Markov-based decision analytic model that simulated Turkish children from aged 6 to 15 years. Two types of costs were explored from the payers' perspective and the health care system perspectives. A cost-effectiveness analysis of resin-based and glass ionomer-based fissure sealants was conducted to quantify their effectiveness using the number of caries prevented and the quality-adjusted tooth years (QATYs). Costs and effectiveness measures were discounted at 3% per year.

Results

The most cost-effective intervention was resin-based fissure sealant, with an additional $5.34 per caries prevented and $1.86 per QATY gained compared with no treatment.

Conclusion

Fissure sealants particularly resin-based sealants are cost-effective for children in Turkey due to their low cost and highly preventive characteristics.

目的评价树脂基和玻璃离聚物基裂隙封闭剂与不干预儿童的成本效益。方法我们开发了一个基于马尔可夫的决策分析模型，模拟土耳其6至15岁的儿童年。从支付者的角度和医疗保健系统的角度探讨了两种类型的成本。对树脂基和玻璃离聚物基裂隙封闭剂进行了成本效益分析，以使用预防龋齿的数量和质量调整牙齿年数（QATYs）来量化其有效性。成本和有效性措施按每年3%的折扣计算。结果最具成本效益的干预措施是树脂基裂隙封闭剂，与不治疗相比，每预防一次龋齿可额外获得5.34美元，每治疗一次可额外获得1.86美元。结论裂缝性密封胶，特别是树脂基密封胶，具有成本低、预防性强的特点，适合土耳其儿童使用。

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引用次数: 0

Safe, supportive neighborhoods: Are they associated with childhood oral health? 安全、支持的社区:它们与儿童口腔健康有关吗?

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-18 DOI: 10.1111/jphd.12541

Elizabeth Crouch PhD, Joni Nelson PhD, Elizabeth Radcliff PhD, Melinda A. Merrell PhD, MPH, Amy Martin DrPH

Objective

There has been limited examination of how community-level supports may influence oral health metrics among children. The purpose of our study is to examine the association between two types of community-level positive childhood experiences and oral healthcare and oral health outcomes among children ages 6 to 17 years of age.

Methods

This study uses a cross-sectional data set from the 2018–2019 National Survey of Children's Health. Two oral health metrics were used: preventive dental care, measured as one or more preventive dental visits in the past 12 months, and tooth decay, measured as tooth decay or cavities in the last 12 months. To quantify living in safe, stable, equitable environments, questions on residing in a safe and supportive neighborhood were used. Descriptive statistics and bivariate analyses were used to calculate frequencies, proportions, and unadjusted associations for each variable (n = 40,290). Multivariable logistic regression models were used.

Results

In an adjusted analysis, children who lived in a supportive neighborhood had a higher likelihood of receiving a preventive dental visit than children who did not live in a supportive neighborhood (aOR 1.41; 95% CI 1.21–1.65). Children who lived in a safe neighborhood were less likely to have tooth decay than children who did not live in a safe neighborhood (aOR 0.75; 95% CI 0.65–0.86).

Conclusions

The findings from this study highlight the role of social structures in tightening the safety net for oral healthcare in children.

目的关于社区支持如何影响儿童口腔健康指标的研究有限。本研究旨在探讨6至17岁儿童的两种社区层面的积极童年经历与口腔保健和口腔健康结果之间的关系。方法本研究使用2018-2019年全国儿童健康调查的横断面数据集。研究使用了两种口腔健康指标:预防性牙科护理，以过去12个月的一次或多次预防性牙科就诊来衡量，以及蛀牙，以过去12个月的蛀牙或蛀牙来衡量。为了量化生活在安全、稳定、公平的环境中，使用了居住在安全和支持性社区的问题。描述性统计和双变量分析用于计算每个变量的频率、比例和未调整的关联(n = 40,290)。采用多变量logistic回归模型。结果在一项调整分析中，生活在支持性社区的儿童比没有生活在支持性社区的儿童接受预防性牙科就诊的可能性更高(aOR 1.41;95% ci 1.21-1.65)。生活在安全社区的儿童比没有生活在安全社区的儿童更不容易蛀牙(aOR 0.75;95% ci 0.65-0.86)。结论本研究结果强调了社会结构在加强儿童口腔保健安全网中的作用。

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引用次数: 0

Refining the process: Safety net dental professionals' experiences with teledentistry implementation during the first year of COVID-19 改进流程:2019冠状病毒病第一年实施远程牙科的安全网牙科专业人员经验

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-18 DOI: 10.1111/jphd.12547

Caroline D. McLeod RDH, MS, Lisa J. Heaton PhD, Katherine Chung-Bridges MD, MPH, Sarah E. Raskin PhD

Objectives

Teledentistry helped dentistry adapt to pandemic-era challenges; little is known about dental professionals' teledentistry experiences during this time. This analysis sought to understand professionals' pandemic teledentistry experiences and expectations for the modality's future.

Methods

We conducted virtual individual interviews (n = 21) via Zoom to understand how federally qualified health centers (FQHCs) delivered oral care during the first year of the pandemic, including but not limited to the use of teledentistry. We independently coded each transcript, then identified themes and sub-themes.

Results

We identified three major themes: (1) Logistical and equity considerations shaped teledentistry's adoption; (2) Team-based factors influenced implementation; and (3) Teledentistry's future is as-yet undetermined.

Conclusions

Experiences with teledentistry during the first year of COVID-19 varied substantially. Future directions should be more deliberate to counter the urgency of pandemic-style implementation and must address appropriate use, reimbursement guidance, patient and provider challenges, and customizability to each clinic's context.

目的:远程牙科帮助牙科适应大流行时代的挑战;在这段时间里，人们对牙科专业人员的远程牙科治疗经验知之甚少。该分析旨在了解专业人员的流行病远程牙科经验和对该模式未来的期望。方法我们通过Zoom进行了虚拟个人访谈(n = 21)，以了解联邦合格卫生中心(fqhc)在大流行的第一年如何提供口腔护理，包括但不限于远程牙科的使用。我们独立编码每个文本，然后确定主题和副主题。结果我们确定了三个主要主题:(1)后勤和公平考虑影响了远程牙科的采用;(2)团队因素影响实施;(3)远程医学的未来尚未确定。结论:COVID-19第一年的远程牙科治疗经验差异很大。未来的方向应该更加慎重，以应对大流行式实施的紧迫性，必须解决适当的使用、报销指导、患者和提供者的挑战以及每个诊所情况的可定制性。

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引用次数: 0

Patterns of fluoride intake from 6 to 17 years of age: The Iowa Fluoride Study 6至17岁氟化物摄入模式:爱荷华州氟化物研究

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-17 DOI: 10.1111/jphd.12542

Pradeep Bhagavatula BDS, MPH, MS, Carissa L. Comnick MS, John J. Warren DDS, MS, Steven M. Levy DDS, MPH

Objectives

This article reports on estimated daily fluoride intake from water, other beverages and selected foods, dentifrice, and dietary fluoride supplements by both individual sources, and all sources combined, among 787 children participating in the Iowa Fluoride Study (IFS) from 6 to 17 years of age.

Methods

Total daily fluoride intake (mg F) and fluoride intake per kilogram bodyweight (mg F/kg bw) were estimated using responses to questionnaires sent every 3–6 months. Dietary assessments included frequencies and amounts of beverage intake for the previous week from water, milk, ready-to-drink beverages, beverages made by adding water to concentrate or powder, and selected foods with substantial water content. Descriptive statistics and bivariate and multivariable analyses with linear mixed models were used to assess associations with each of mg F and mg F/kg bw.

Results

Mean combined dietary fluoride (mg F) from all sources examined in the study increased slightly with age, whereas the fluoride intake per kg bw decreased with age. Age, sex, and socioeconomic status were significantly associated with fluoride intake (mg F and mg F/kg bw). Each year increase in age was associated with a 0.02-mg increase in fluoride consumption, on average, after adjusting for the effects of covariates.

Conclusions

Daily mean fluoride intakes from single and combined sources were relatively stable, while the intake of fluoride per kg bw decreased from 6 to 17 years of age. Fluoridated water was the major source of ingested fluoride, contributing over 50% of total daily intake at all ages.

本研究报告了参与爱荷华州氟化物研究(IFS)的787名6至17岁儿童每日从水、其他饮料和选定食品、牙膏和膳食氟化物补充剂中摄入的氟化物的估算值，包括单独来源和所有来源。方法通过3 ~ 6个月一次的问卷调查，估算每日总氟摄入量(mg F)和每千克体重氟摄入量(mg F/kg bw)。饮食评估包括前一周的饮料摄入频率和数量，包括水、牛奶、即饮饮料、通过加水制成的浓缩或粉末饮料，以及选定的含有大量水分的食物。采用描述性统计、双变量和多变量线性混合模型分析来评估mg F和mg F/kg bw之间的相关性。结果:研究中所有来源的平均膳食氟化物(mg F)随年龄的增长略有增加，而每公斤体重的氟化物摄入量随年龄的增长而下降。年龄、性别和社会经济地位与氟摄入量(mg F和mg F/kg bw)显著相关。在对协变量的影响进行调整后，年龄每增加一年，氟化物消耗量平均增加0.02毫克。结论6 ~ 17岁儿童日平均氟摄入量相对稳定，每kg bw氟摄入量呈下降趋势。氟化水是摄入氟化物的主要来源，占所有年龄段每日总摄入量的50%以上。

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引用次数: 0

Development of quality measures to assess tooth decay outcomes from electronic health record data 制定质量措施，根据电子健康记录数据评估蛀牙结果

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-12 DOI: 10.1111/jphd.12545

Ryan G. Brandon BS, Suhasini Bangar BDS, MS, Alfa Yansane PhD, Ana Neumann DDS, MPH, PhD, Joanna M. Mullins RDH, BSDH, MHI, Elsbeth Kalenderian DDS, MPH, PhD, Muhammad F. Walji MS, PhD, Joel M. White DDS, MS

Objectives

To develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay.

Methods

Quality measures were developed to assess whether decay was treated within 6 months and if new decay occurred in patients seen. Using EHR-derived data of the state of each tooth surface, algorithms compared the patient's teeth at different dates to determine if decay was treated or new decay had occurred. Manual chart reviews were conducted at three sites to validate the measures. The measures were implemented and scores were calculated for three sites over four calendar years, 2016 through 2019.

Results

About 954 charts were manually reviewed for the timely treatment of tooth decay measure, with measure performance of sensitivity 97%, specificity 85%, positive predictive value (PPV) 91%, negative predictive value (NPV) 95%. About 739 charts were reviewed for new decay measure, with sensitivity 94%, specificity 99%, PPV 99%, and NPV 94%. Across all sites and years, 52.8% of patients with decay were fully treated within 6 months of diagnosis (n = 247,959). A total of 23.8% of patients experienced new decay, measured at an annual exam (n = 640,004).

Conclusion

Methods were developed and validated for assessing timely treatment of decay and occurrence of new decay derived from EHR data, creating effective outcome measures. These EHR-based quality measures produce accurate and reliable results that support efforts and advancement in quality assessment, quality improvement, patient care and research.

目的制定基于牙科电子健康记录（EHR）的护理质量测量结果，以评估蛀牙的发生和及时治疗。方法制定质量措施，以评估衰变是否在6 几个月，如果患者出现新的蛀牙。使用EHR导出的每个牙齿表面状态的数据，算法比较了患者在不同日期的牙齿，以确定是否治疗了蛀牙或发生了新的蛀牙。在三个地点进行了手动图表审查，以验证这些措施。这些措施已经实施，并在2016年至2019年的四个日历年内计算了三个地点的分数。结果约954张图表用于蛀牙测量的及时治疗，测量性能为敏感性97%，特异性85%，阳性预测值（PPV）91%，阴性预测值（NPV）95%。对大约739张图表进行了新的衰变测量，灵敏度为94%，特异性为99%，PPV为99%，NPV为94%。在所有部位和年份，52.8%的蛀牙患者在诊断后6个月内得到了充分治疗（n=247959）。在年度检查中，共有23.8%的患者出现新的蛀牙（n=640004）。结论根据EHR数据，开发并验证了评估蛀牙及时治疗和新蛀牙发生的方法，制定了有效的结果测量方法。这些基于EHR的质量测量产生了准确可靠的结果，支持在质量评估、质量改进、患者护理和研究方面的努力和进步。

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引用次数: 1

Estimation of oral disease burden from claims and self-reported data 从索赔和自我报告数据估计口腔疾病负担

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-12 DOI: 10.1111/jphd.12550

Christopher Okunseri BDS, MSc, FFDRCSI, Julie Frantsve-Hawley PhD, Madhuli Thakkar-Samtani BDS, MPH, IIya Okunev MA, Lisa J. Heaton PhD, Eric P. Tranby PhD

Objective

To compare the use of Medicaid and commercial claims data with self-reported survey data in estimating the prevalence of oral disease burden.

Methods

We analyzed 2018 Medicaid claims from the IBM Watson Medicaid Marketscan database, commercial claims from the IBM Dental Database, and Medical Expenditure Panel Survey (MEPS) data. The estimate of oral disease burden was based on standard metrics using periodontal and caries-related Current Dental Terminology (CDT) procedure codes. A direct comparison between the data sets was also done.

Results

Unweighted Medicaid and commercial enrollees were 11.6 and 10.5 million, respectively. The weighted proportion from MEPS for Medicaid and commercial plans ranged from 80 to 208 million people. Estimates of caries-related treatments were calculated from IBM Watson and MEPS data for Medicaid enrollees (13% vs. 12%, respectively) and commercial claims (25% vs. 17%, respectively). Prevalence of periodontal related treatments for those with a dental visit was estimated for IBM Watson and MEPS enrollees for Medicaid (0.7% vs. 0.5%, respectively) and commercial claims (7% vs. 1.6%, respectively). Dental disease estimates were higher in individuals with at least one dental visit across cohorts. Prevalence of disease for those with a dental visit based on specific procedures were higher in commercial plans than in Medicaid.

Conclusions

Claims data has the potential to serve as a proxy measure for the estimate of dental disease burden in a population.

目的比较医疗补助和商业索赔数据与自我报告调查数据在估计口腔疾病负担流行率方面的应用。方法:我们分析了IBM Watson Medicaid Marketscan数据库中的2018年医疗补助索赔、IBM牙科数据库中的商业索赔和医疗支出小组调查(MEPS)数据。口腔疾病负担的估计是基于使用与牙周和龋齿相关的现行牙科术语(CDT)程序代码的标准度量。还对数据集进行了直接比较。结果未加权的医疗补助和商业参保人数分别为1160万和1050万。医疗补助和商业计划的MEPS加权比例从8000万到2.08亿不等。根据IBM Watson和MEPS的医疗补助计划参保者(分别为13%和12%)和商业索赔(分别为25%和17%)的数据计算龋齿相关治疗的估计。对IBM Watson和MEPS医疗补助计划参保者(分别为0.7%和0.5%)和商业索赔参保者(分别为7%和1.6%)进行牙周相关治疗的流行率估计。在所有队列中，至少有一次牙科就诊的个体的牙病估计较高。根据特定程序进行牙科检查的患者，商业计划的患病率高于医疗补助计划。结论索赔数据有可能作为估计人群牙病负担的替代措施。

{"title":"Estimation of oral disease burden from claims and self-reported data","authors":"Christopher Okunseri BDS, MSc, FFDRCSI, Julie Frantsve-Hawley PhD, Madhuli Thakkar-Samtani BDS, MPH, IIya Okunev MA, Lisa J. Heaton PhD, Eric P. Tranby PhD","doi":"10.1111/jphd.12550","DOIUrl":"10.1111/jphd.12550","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the use of Medicaid and commercial claims data with self-reported survey data in estimating the prevalence of oral disease burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 2018 Medicaid claims from the IBM Watson Medicaid Marketscan database, commercial claims from the IBM Dental Database, and Medical Expenditure Panel Survey (MEPS) data. The estimate of oral disease burden was based on standard metrics using periodontal and caries-related Current Dental Terminology (CDT) procedure codes. A direct comparison between the data sets was also done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Unweighted Medicaid and commercial enrollees were 11.6 and 10.5 million, respectively. The weighted proportion from MEPS for Medicaid and commercial plans ranged from 80 to 208 million people. Estimates of caries-related treatments were calculated from IBM Watson and MEPS data for Medicaid enrollees (13% vs. 12%, respectively) and commercial claims (25% vs. 17%, respectively). Prevalence of periodontal related treatments for those with a dental visit was estimated for IBM Watson and MEPS enrollees for Medicaid (0.7% vs. 0.5%, respectively) and commercial claims (7% vs. 1.6%, respectively). Dental disease estimates were higher in individuals with at least one dental visit across cohorts. Prevalence of disease for those with a dental visit based on specific procedures were higher in commercial plans than in Medicaid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Claims data has the potential to serve as a proxy measure for the estimate of dental disease burden in a population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"83 1","pages":"51-59"},"PeriodicalIF":2.3,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of dentists' availability in delivering dental care in Florida Elementary Schools 牙医在佛罗里达州小学提供牙科护理的可用性的影响

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2022-10-11 DOI: 10.1111/jphd.12551

Simin Ma MS, Nicoleta Serban PhD, Amin Dehghanian PhD, Scott L. Tomar DMD, MPH

Objective

This study evaluates the dentists' availability to deliver preventive dental care to children in schools and the impact of school-based programs on access.

Methods

The study population included Florida elementary-school children, differentiated by dental insurance (Medicaid, CHIP, private, or none). We considered the implementation of school-based programs using optimization modeling to (re)allocate the dentists' caseload to schools to meet demand for preventive care under resource constraints. We considered multiple settings for school-based program implementation: (i) school prioritization; and (ii) dentists' participation in public insurance. Statistical inference was used to identify communities to improve access and reduce disparities.

Results

School-based programs reduced unmet demand (3%–12%), being more efficient if prioritizing schools in communities targeted to improve access. The access improvement varied by insurance status and geography. Uninsured urban children benefited most from school-based programs, with 15%–75% unmet need reduction. The percentage of urban communities targeted to improve access decreased by 12% against no-school program. Such percentage remained large for suburban (15%–100%) and rural (50%–100%) communities. Disparity in access for public-insured vs. private-insured children persisted under school-based programs (32%–84% identified communities).

Conclusion

School-based programs improve dental care access; the improvement was however different by insurance status, with uninsured children benefiting the most. Accounting to the dentists' availability in prioritizing schools resulted in effective resource allocation to school-based programs. Access disparities between public and private-insured children did not improve; school-based programs shifted resources from public-insured to uninsured. School-based programs are effective in addressing access barriers to those children experiencing them most.

目的本研究评估牙科医生在学校为儿童提供预防性牙科护理的可获得性，以及学校为基础的项目对可获得性的影响。方法研究人群包括佛罗里达州小学儿童，根据牙科保险(医疗补助、CHIP、私立或无)进行区分。我们考虑实施以学校为基础的项目，使用优化模型(重新)分配牙医的病例量到学校，以满足资源限制下对预防保健的需求。我们考虑了以学校为基础的项目实施的多种设置:(1)学校优先级;以及(ii)牙医参加公共保险的情况。统计推断用于确定社区，以改善获取和减少差距。结果:以学校为基础的项目减少了未满足的需求(3%-12%)，如果优先考虑以改善入学为目标的社区的学校，则效率会更高。获得改善的情况因保险状况和地理位置而异。未参保的城市儿童从学校项目中受益最多，未满足的需求减少了15%-75%。与无学校计划相比，改善教育机会的城市社区比例下降了12%。这一比例在郊区(15%-100%)和农村(50%-100%)社区仍然很高。在以学校为基础的项目中，公共保险与私人保险儿童获得机会的差距仍然存在(32%-84%确定的社区)。结论:校本项目提高了牙科保健的可及性;然而，不同的保险状况也有不同的改善，没有保险的孩子受益最多。考虑到牙医在优先考虑学校方面的可用性，有效地将资源分配给以学校为基础的项目。公立和私立医疗保险儿童在获取医疗服务方面的差距没有改善;以学校为基础的项目将资源从公共保险转移到无保险人群。以学校为基础的项目有效地解决了那些经历最多障碍的儿童的入学障碍。

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引用次数: 0