Dental Services and Health Outcomes in the New York State Medicaid Program.
Dental Services and Health Outcomes in the New York State Medicaid Program.
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DOI：
10.1177/00220345211007448
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发表时间：
2021-08
影响因子：
7.6
通讯作者：
Alfano MC
中科院分区：
文献类型：
--
作者：
Lamster IB;Malloy KP;DiMura PM;Cheng B;Wagner VL;Matson J;Proj A;Xi Y;Abel SN;Alfano MC
以前的报告表明，牙周治疗与改善卫生保健结果和降低费用有关。利用纽约州医疗补助计划的数据，研究了急诊科（ED）使用率和住院率（ip），以及急诊科、ip、药房和总体卫生保健的成本，以确定预防性牙科保健与卫生保健结果的关系。将前两年（2012年7月至2014年6月）的牙科服务利用情况与最后一年（2014年7月至2015年6月）的保健结果进行比较。将未接受牙科服务（No dental）的成员的成本和利用率与接受任何牙科护理（any dental）、任何预防性牙科护理（PDC）、不进行拔牙和/或牙髓治疗的PDC（不进行Ext/Endo的PDC）、带Ext/Endo的PDC（带Ext/Endo的PDC）或不进行PDC的Ext/Endo（不进行PDC的Ext/Endo）的成员进行比较。倾向得分用于调整潜在的混杂因素。调整后，PDC和PDC不带Ext/Endo的ED比率明显较低，而Any Dental和Ext/Endo不带PDC的ED比率较高。除没有PDC的Ext/Endo外，所有治疗组的IP比率都较低。除了没有PDC的Ext/Endo外，ED费用与无牙科组相比差异不大。对于ip，除了没有PDC的Ext/Endo外，所有组的人均成本都显着降低（- 262.91美元[95%置信区间（CI）， - 325.40至- 200.42]至- 379.82美元[95% CI， - 451.27至- 308.37]）。对于总医疗成本，没有PDC的Ext/Endo的总医疗成本显著更高（530.50美元[95% CI， 156.99-904.01]）。每增加一次PDC检查，ED的相对风险降低3%，IPs的相对风险降低9%。总的医疗保健费用（- 235.64美元[95% CI， - 299.95至- 171.33]）和IP（- 181.39美元[95% CI， - 208.73至- 154.05]）也有所下降。总之，观察到PDC与改善的医疗保健结果之间存在关联，而没有PDC的Ext/Endo则相反。
Previous reports suggest that periodontal treatment is associated with improved health care outcomes and reduced costs. Using data from the New York State Medicaid program, rates of emergency department (ED) use and inpatient admissions (IPs), as well as costs for ED, IPs, pharmacy, and total health care, were studied to determine the association of preventive dental care to health care outcomes. Utilization of dental services in the first 2 y (July 2012–June 2014) was compared to health care outcomes in the final year (July 2014–June 2015). Costs and utilization for members who did not receive dental services (No Dental) were compared to those who received any dental care (Any Dental), any preventive dental care (PDC), PDC without an extraction and/or endodontic treatment (PDC without Ext/Endo), PDC with an Ext/Endo (PDC with Ext/Endo), or Ext/Endo without PDC (Ext/Endo without PDC). Propensity scores were used to adjust for potential confounders. After adjustment, ED rate ratios were significantly lower for PDC and PDC without Ext/Endo but higher for the Any Dental and Ext/Endo without PDC. IP ratios were lower for all treatment groups except Ext/Endo without PDC. ED costs differed little compared to the No Dental group except for Ext/Endo without PDC. For IPs, costs per member were significantly lower for all groups (−$262.91 [95% confidence interval (CI), −325.40 to −200.42] to −$379.82 [95% CI, −451.27 to −308.37]) except for Ext/Endo without PDC. For total health care costs, Ext/Endo without PDC had a significantly greater total health care cost ($530.50 [95% CI, 156.99–904.01]). Each additional PDC visit was associated with a 3% reduction in the relative risk for ED and 9% reduction for IPs. Costs also decreased for total health care (−$235.64 [95% CI, −299.95 to −171.33]) and IP (−$181.39 [95% CI, −208.73 to −154.05]). In conclusion, an association between PDC and improved health care outcomes was observed, with the opposite association for Ext/Endo without PDC.
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影响因子：
2.9
作者：
Teshome A;Yitayeh A
通讯作者：
Yitayeh A
影响因子：
2.3
作者：
Lamster, Ira B;Myers-Wright, Noreen
通讯作者：
Myers-Wright, Noreen
影响因子：
7.6
作者：
Caplan, D. J.;Chasen, J. B.;Beck, J. D.
通讯作者：
Beck, J. D.
影响因子：
--
作者：
Southerland, Janet H;Webster-Cyriaque, Jennifer;Mouton, Charles P
通讯作者：
Mouton, Charles P
牙周治疗对与糖尿病相关的医疗保健成本的影响：一项回顾性研究。
影响因子：
4.1
作者：
Smits KPJ;Listl S;Plachokova AS;Van der Galien O;Kalmus O
通讯作者：
Kalmus O