A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State.
A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State.
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DOI：
10.3389/froh.2022.1031443
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发表时间：
2022
影响因子：
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通讯作者：
Gold, Heather T
中科院分区：
文献类型：
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作者：
Burns, Lorel E;Gencerliler, Nihan;Terlizzi, Kelly;Wu, Yinxiang;Solis-Roman, Claudia;Gold, Heather T
本研究调查了在一个公共保险的儿童和青少年队列中提供根管治疗和结果的差异。分析了2006年至2018年的纽约州医疗补助行政索赔。年龄在6-18岁之间的参与者如果在恒牙列中进行了初始非手术根管治疗（NSRCT），并且允许至少1年的治疗后随访，则被纳入研究。采用描述性分析、多变量逻辑回归和多变量考克斯比例风险模型来检查人口统计学变量（性别、年龄、种族/民族和基于地区的因素）与牙科治疗提供和结果之间的关联。男性与有一个以上的初始NSRCT相关（调整后的比值比（aOR）= 1.06; 95%置信区间（CI）= 1.02-1.10），农村也是如此（aOR = 1.15; 95% CI = 1.06-1.24）。与非西班牙裔白色儿童相比，黑人/非裔美国人（AA）和西班牙裔儿童发生多个NSRCT的可能性较小（aOR = 0.88; 95% CI = 0.83-0.93和aOR = 0.78; 95% CI = 0.74-0.83）。年龄较大或女性的不良事件风险较低（aHR = 0.93; 95% CI = 0.92-0.94和aHR = 0.86; 95% CI = 0.81-0.91）。与非西班牙裔白色儿童相比，西班牙裔和黑人/AA儿童的不良事件风险更高（aHR = 1.31; 95% CI = 1.21-1.41和aHR = 1.55; 95% CI = 1.43-1.67），而亚裔儿童在初始NSRCT后的发生率更低（aHR = 0.79; 95% CI = 0.71-0.88）。种族/民族是该队列中提供初始非手术根管治疗，随后放置永久修复体和NSRCT后发生不良事件的最强人口统计学预测因素。
This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6–18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02–1.10), as was rurality (aOR = 1.15; 95% CI = 1.06–1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83–0.93 and aOR = 0.78; 95% CI = 0.74–0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92–0.94 and aHR = 0.86; 95% CI = 0.81–0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21–1.41 and aHR = 1.55; 95% CI = 1.43–1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71–0.88). Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.