Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures
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DOI：
10.1016/j.adaj.2018.08.010
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Decker, Sandra L.
中科院分区：
文献类型：
--
作者：
Abdus, Salam;Decker, Sandra L.
背景。只有一些州为成年医疗补助计划参保人提供非紧急牙科服务。本研究考察了医疗补助成人非紧急牙科服务的覆盖范围与牙科服务的使用和支出之间的关系。作者分析了2000年至2015年医疗支出小组调查家庭组成部分的数据，其中包括21岁或以上参加医疗补助计划的成年人。作者调查了一系列结果，如牙科就诊、预防和其他5种牙科服务，以及牙科总费用和自付费用。使用多元回归模型来估计医疗补助计划参保者在提供非紧急牙科服务的州和不提供医疗补助计划参保者之间的结果差异，控制潜在的混杂因素。与不提供医疗保险的州的医疗补助参保人相比，提供非紧急牙科服务的州的参保人接受牙科检查的可能性大约高出9个百分点，接受任何预防性牙科服务的可能性大约高出7个百分点，接受除口腔手术服务以外的所有其他类型牙科服务的可能性更高。在任何一次就诊的参保人中，有医保覆盖的州的自付牙科费用比无医保覆盖的州低约19个百分点。医疗补助成人非紧急牙科福利与预防性和其他类型牙科服务的较高使用率以及较低的自付牙科费用份额相关。实际意义。我们的研究结果可能有助于决策者考虑通过医疗补助改善成年人牙齿健康的方法。
Background. Only some states provide coverage of nonemergency dental services for adult Medicaid enrollees. This study examined the association between coverage of Medicaid adult nonemergency dental services and dental services use and expenditures.Methods. The authors analyzed data from the 2000 through 2015 Medical Expenditure Panel Survey Household Component for adults 21 years or older enrolled in Medicaid. The authors examined a range of outcomes such as dental visits, preventive and 5 other types of dental services, and total and out-of-pocket dental expenditures. Multivariate regression models were used to estimate the differences in outcomes for Medicaid enrollees between states that provided coverage of nonemergency dental services and states that did not, controlling for potentially confounding factors.Results. Compared with Medicaid enrollees in states that did not provide coverage, enrollees in states that provided coverage of nonemergency dental services were approximately 9 percentage points more likely to have a dental visit, approximately 7 percentage points more likely to have any preventive dental service, and more likely to have all other types of dental services except oral surgery services. Among enrollees with any visit, out-of-pocket share of dental expenditures was approximately 19 percentage points lower among those in covered states than those in uncovered states.Conclusions. Medicaid adult nonemergency dental benefits were associated with higher use of preventive and other types of dental services and lower out-of-pocket share of dental costs.Practical Implications. Our results may help inform policy makers as they consider ways of improving dental health of adults through Medicaid.