Examining Continuity of Care for Medicaid-Enrolled Children Receiving Oral Health Services in Medical Offices

详细信息    查看全文

• 作者：Ashley M. Kranz ; R. Gary Rozier ; John S. Preisser…
• 关键词：Medicaid ; Access to care ; Continuity of care ; Oral health ; Dental care ; Pediatric
• 刊名：Maternal and Child Health Journal
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：19
• 期：1
• 页码：196-203
• 全文大小：230 KB
• 参考文献：1. American Academy of Pediatric Dentistry. (2009). / Guideline on periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children, and adolescents. http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf. Accessed February 8, 2013.
  2. American Academy of Pediatrics. (2003). Oral health risk assessment timing and establishment of the dental home. / Pediatrics, / 111(5), 1113-116. CrossRef
  3. American Dental Association. (2002). Baby’s first teeth. / Journal of the American Dental Association, / 133, 255. CrossRef
  4. Hakim, R. B., Babish, J. D., & Davis, A. C. (2012). State of dental care among Medicaid-enrolled children in the united states. / Pediatrics, / 130(1), 5-4. CrossRef
  5. Long, C. M., et al. (2012). Pediatricians-assessments of caries risk and need for a dental evaluation in preschool aged children. / BMC Pediatrics, / 12(1), 49-6. CrossRef
  6. Edelstein, B. L., & Chinn, C. H. (2009). Update on disparities in oral health and access to dental care for America’s children. / Academic Pediatrics, / 9(6), 415-19. CrossRef
  7. U.S. Government Accountability Office. (2010). / Efforts under way to improve children’s access to dental services, but sustained attention needed to address ongoing concerns. Washington, DC: U.S. Government Accountability Office. http://www.gao.gov/new.items/d1196.pdf.
  8. Institute of Medicine. (2009). / The U.S. oral health workforce in the coming decade: Workshop summary. Washington, DC: The National Academies Press.
  9. North Carolina Oral Health Section. (2012). / Into the Mouths of Babes. http://www.ncdhhs.gov/dph/oralhealth/partners/IMB.htm. Accessed December 2, 2012.
  10. Sams, L. D., et al. (2013). Adoption and implementation of policies to support preventive dentistry initiatives for physicians: A national survey of Medicaid programs. / American Journal of Public Health, / 103(8), e83–e90. CrossRef
  11. Okunseri, C., et al. (2009). Increased children’s access to fluoride varnish treatment by involving medical care providers: Effect of a Medicaid policy change. / Health Services Research, / 44(4), 1144-156. CrossRef
  12. Pahel, B. T., et al. (2011). Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees. / Pediatrics, / 127(3), e682–e689. CrossRef
  13. Rozier, R. G., et al. (2010). How a North Carolina program boosted preventive oral health services for low-income children. / Health Affairs, / 29(12), 2278-285. CrossRef
  14. Stearns, S. C., et al. (2012). Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees. / Archives of Pediatrics and Adolescent Medicine, / 166(10), 945-51. CrossRef
  15. American Academy of Pediatric Dentistry. (2012). / Policy on the dental home. dentalhome.pdf" class="a-plus-plus">http://www.aapd.org/media/policies_guidelines/p_dentalhome.pdf. Accessed December 17, 2012.
  16. Deinard, A. (2013). / State medicaid payment for caries prevention services by non-dental professionals. http://www2.aap.org/commpeds/dochs/oralhealth//docs/OHReimbursementChart.pdf. Accessed July 25, 2013.
  17. Bright Futures and the American Academy of Pediatrics. (2008). / Recommendations for preventive pediatric health ca
• 刊物主题：Public Health; Sociology, general; Population Economics; Pediatrics; Gynecology; Maternal and Child Health;
• 出版者：Springer US
• ISSN：1573-6628

文摘

Children living in poverty encounter barriers to dentist visits and disproportionally experience dental caries. To improve access, most state Medicaid programs reimburse pediatric primary care providers for delivering preventive oral health services. To understand continuity of oral health services for children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, we examined the time to a dentist visit after a child’s third birthday. This retrospective cohort study used NC Medicaid claims from 2000 to 2006 for 95,578 Medicaid-enrolled children who received oral health services before age 3. We compared children having only dentist visits before age 3 to those with: (1) only IMB visits and (2) both IMB and dentist visits. Cox proportional hazards regression was used to estimate the time to a dentist visit following a child’s third birthday. Propensity scores with inverse-probability-of-treatment-weights were used to address confounding. Children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday [adjusted hazard ratio?(AHR)?=?0.41, 95?% confidence interval (CI) 0.39-.43]. No difference was observed for children having both IMB and dentist visits and only dentist visits (AHR?=?0.99, 95?% CI 0.96-.03). Barriers to dental care remain as children age, hindering continuity of care for children receiving oral health services in medical offices.