Impact on Dental Utilization of the Integration of Oral Health in Pediatric Primary Care Through Quality Improvement

被引:2
作者
Danesh, David O. [1 ,4 ,8 ]
Peng, Jin [4 ,7 ]
Hammersmith, Kimberly J. [1 ,4 ]
Gowda, Charitha [2 ,5 ]
Maciejewski, Heather [5 ]
Amini, Homa [1 ,4 ]
Wapner, Andrew W. [3 ,6 ]
Meyer, Beau D. [1 ,4 ]
机构
[1] Ohio State Univ, Coll Dent, Div Pediat Dent, Columbus, OH USA
[2] Ohio State Univ, Dept Pediat, Coll Med, Columbus, OH USA
[3] Ohio State Univ, Coll Publ Hlth, Div Hlth Serv Management & Policy, Columbus, OH USA
[4] Nationwide Childrens Hosp, Dept Dent, Columbus, OH USA
[5] Nationwide Childrens Hosp, Partners Kids, Columbus, OH USA
[6] Nationwide Childrens Hosp, Div Emergency Med, Columbus, OH USA
[7] Nationwide Childrens Hosp, Informat Technol Res & Innovat, Columbus, OH USA
[8] Nationwide Childrens Hosp, Dept Dent, 380 Butterfly Gardens, Columbus, OH 43215 USA
关键词
dental; oral health; health service delivery; public health practice; quality of care; MEDICAID-ENROLLED CHILDREN; FLUORIDE VARNISH; SERVICES; PHYSICIANS; PROVISION; RECEIPT; ACCESS; CARIES;
D O I
10.1097/PHH.0000000000001689
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives:To evaluate child-level dental utilization and expenditure outcomes based on if and where children received fluoride varnish (FV) at quality improvement (QI) medical practices, at non-QI medical practices, at dental practices, or those who never received FV from any practice. Design:Retrospective claims-based analysis cohort study. Setting:Children with Medicaid insurance through an Ohio pediatric accountable care organization. Participants:Children aged 1 to 5 years with 1 or more well-child visits between 2015 and 2017. Intervention:FV receipt versus no FV. Among children who received FV, categorized if FV delivered by a QI-participating medical provider, a non-QI-participating medical provider, and a dental provider. Main Outcome Measure:Dental claims from 2014 to 2019 were collected for preventive dental visits, caries-related treatment visits, dental general anesthesia (GA) visit, and emergency department visit for a dental problem to examine utilization patterns, expenditures, and dental outcomes. Results:The QI group had a significantly higher incidence of preventive dental visits than the dental (incidence rate ratio [IRR] = 0.93; 95% confidence interval [CI], 0.91-0.96) or non-QI groups (IRR = 0.86; 95% CI, 0.84-0.88). Compared with the QI group, the non-QI (adjusted odds ratio [aOR] = 2.6; 95% CI, 2.4-2.9) and dental (aOR = 2.9; 95% CI, 2.6-3.3) groups were significantly more likely to have caries-related treatment visits. The dental group children were significantly more likely to have dental treatment under GA than the QI group (aOR = 5.3; 95% CI, 2.0-14.4). Conclusions:Children seen at QI practices appear to have an increased uptake of preventive dental services, which may explain the lower incidence of dental caries visits and GA treatment.
引用
收藏
页码:186 / 195
页数:10
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