13 research outputs found
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)
A Scoping Review of the Roles, Training, and Impact of Community Health Workers in Oral Health Supplemental Tables
Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion criteria, most took place in the United States (n=15) with most published between 2012 and 2019 (12). CHWs were incorporated in programs that focused on access to dental care (n=10), oral health promotion only (9), early childhood caries (8), oral health promotion and services (5), and oral cancer screening (4). Common roles included providing oral health education and behavior change motivation to community members, facilitating utilization of dental services, and the delivery of diagnostic and dental services to community members. Training and outcomes were not consistently described across studies. Conclusion: CHWs have been used in oral health programs and interventions across a wide range of locations and contexts. The implementation and scaling-up of oral health CHW programs requires appropriate provision of training as well as community embedded monitoring and evaluation structures based on rigorous methods with clearly defined outcomes
Lack of resistance to integrase inhibitors among antiretroviral-naive subjects with primary HIV-1 infection, 2007–2013
Automated, high-throughput derivation, characterization and differentiation of induced pluripotent stem cells
Evolution of genes and genomes on the Drosophila phylogeny
Comparative analysis of multiple genomes in a phylogenetic framework dramatically improves the precision and sensitivity of evolutionary inference, producing more robust results than single-genome analyses can provide. The genomes of 12 Drosophila species, ten of which are presented here for the first time (sechellia, simulans, yakuba, erecta, ananassae, persimilis, willistoni, mojavensis, virilis and grimshawi), illustrate how rates and patterns of sequence divergence across taxa can illuminate evolutionary processes on a genomic scale. These genome sequences augment the formidable genetic tools that have made Drosophila melanogaster a pre-eminent model for animal genetics, and will further catalyse fundamental research on mechanisms of development, cell biology, genetics, disease, neurobiology, behaviour, physiology and evolution. Despite remarkable similarities among these Drosophila species, we identified many putatively non-neutral changes in protein-coding genes, non-coding RNA genes, and cis-regulatory regions. These may prove to underlie differences in the ecology and behaviour of these diverse species