53 research outputs found
Rural–Urban Differences in Dental Service Use Among Children Enrolled in a Private Dental Insurance Plan in Wisconsin: Analysis of Administrative Data
Background
Studies on rural–urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural–urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). Methods
We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Results
Approximately, 50%, 67% and 68 % of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. Conclusions
We found significant geographic variation in dental procedures received by children enrolled in DDWI
Rural–Urban Differences in Dental Service Use Among Children Enrolled in a Private Dental Insurance Plan in Wisconsin: Analysis of Administrative Data
Background
Studies on rural–urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural–urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). Methods
We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Results
Approximately, 50%, 67% and 68 % of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. Conclusions
We found significant geographic variation in dental procedures received by children enrolled in DDWI
Development of an Oral Health Survey: Columbus, Ohio
This article describes the method used to develop and implement a local oral health survey (Columbus, Ohio) conducted in 1986. With the shift in the national dental disease pattern in the past decade, local oral health information is essential for program planning purposes. A collaborative effort by a city health department, a state health department, a dental school, and a school of public health demonstrated how this group worked harmoniously in a relatively inexpensive venture to determine the oral status of various age groups (grades 1–2, grades 6–7, age 35–44, and age 65 +). This information provided part of the framework for a five-year dental plan at the Columbus Health Department. The survey design will serve as a basis for conducting a similar survey statewide. Modifications of existing oral health survey instruments are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65714/1/j.1752-7325.1988.tb03177.x.pd
Assessment of the Dental Pipeline Program from the External Reviewers and National Program Office
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153694/1/jddj002203372009732suppltb04693x.pd
Predicting dentists decisions: a choice-based conjoint analysis of Medicaid participation
Objectives: Private practice dentists are the major source of care for the dental
safety net; however, the proportion of dentists who participate in state Medicaid
programs is low, often due to poor perceptions of the program’s administration
and patient population. Using a discrete choice experiment and a series of
hypothetical scenarios, this study evaluated trade-offs dentists make when deciding
to accept Medicaid patients.
Methods: An online choice-based conjoint survey was sent to 272 general dentists
in Iowa. Hypothetical scenarios presented factors at systematically varied levels.
The primary determination was whether dentists would accept a new Medicaid
patient in each scenario. Using an ecological model of behavior, determining
factors were selected from the categories of policy, administration, community, and
patient population to estimate dentists’ relative preferences.
Results: 62 percent of general dentists responded to the survey. The probability of
accepting a new Medicaid patient was highest (81 percent) when reimbursement
rates were 85 percent of the dentist’s fees, patients never missed appointments,
claims were approved on first submission, and no other practices in the area
accepted Medicaid. Although dentists preferred higher reimbursement rates, 56
percent would still accept a new Medicaid patient when reimbursement decreased
to 55 percent if they were told that the patient would never miss appointments and
claims would be approved on initial submission.
Conclusions: This study revealed trade-offs that dentists make when deciding to
participate in Medicaid. Findings indicate that states can potentially improve
Medicaid participation without changing reimbursement rates by making
improvements in claims processing and care coordination to reduce missed
appointments.Funding for this project came from an Innovation Fund for
Oral Health award from the DentaQuest Foundation (Boston,
MA)
Fluoride Exposure in Michigan Schoolchildren
Recent trends in the prevalence of dental caries in children, as well as a possible increase in the prevalence of dental fluorosis, have prompted some researchers to suggest the reassessment of water fluoride concentration standards. Instead of reducing water fluoride concentrations, an alternative approach would be to limit the use of, or reduce the fluoride concentration of, dentifrices, mouthrinses, and supplements. Information about the use of these other sources of fluoride, however, is scarce. Using data from a 1987 survey of Michigan schoolchildren, exposure to selected fluoride sources as well as tooth brushing habits are described. Responses from questionnaires revealed that, overall, 98.5 percent of the children have used fluoride dentifrices, 27 percent have used topical fluoride rinses, 72.5 percent have had at least one exposure to professionally applied topical fluoride, and 27percent have used dietary fluoride supplements. Although the use of fluoride dietary supplements was appropriate for most children residing in fluoride-deficient Cadillac, the percentages of children in the other communities who have ingested these supplements suggest that these products are being prescribed improperly. Given the almost universal use of fluoride dentifrices at an early age, it may be time to investigate the use of reduced fluoride dentifrices for children. In addition, continuing efforts to decrease inappropriate dietary fluoride supplementation are required.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65672/1/j.1752-7325.1990.tb03552.x.pd
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