Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans
Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans
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DOI：
10.1111/jphd.12191
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发表时间：
2017-12-01
影响因子：
2.3
通讯作者：
Okunseri, Christopher
中科院分区：
文献类型：
--
作者：
Bhagavatula, Pradeep;Xiang, Qun;Okunseri, Christopher
背景：很少有研究直接比较公共和私人保险计划为居住在牙科卫生专业人员短缺地区（DHPSAs）的参保人提供的牙科手术。我们调查了2002年至2008年间，居住在DHPSAs和非DHPSAs的0-18岁儿童接受不同类型牙科手术的比率，这些儿童参加了医疗补助计划和威斯康星州三角洲牙科（DDW）。方法对2002 ~ 2008年医疗补助和DDW牙科索赔数据进行分析。受试者被分为DDW-DHPSA组和非dhpsa组、Medicaid-DHPSA组和非dhpsa组。使用过分散泊松回归进行了描述性和多变量分析，以检验居住在dhpsa和保险类型与接受手术次数的关系。结果大约49%和65%生活在非dhpsa地区的儿童分别参加了医疗补助计划和DDW计划，每年至少接受一次预防性牙科手术。与Medicaid非dhpsa组相比，DDW非dhpsa组儿童预防性治疗次数为1.79倍，复杂修复治疗次数为0.27倍，牙髓治疗次数为0.51倍。与医疗补助- dhpsa组相比，DDW-DHPSA组儿童的预防性手术次数为1.53倍，复杂的恢复性手术次数为0.25倍。结论ddw参保儿童对预防措施的使用率明显高于医疗补助参保儿童。在医疗补助和DDW中，非DHPSA和DHPSA在大多数牙科治疗中有显著差异。
BackgroundFew studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008.MethodsMedicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received.ResultsApproximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group.ConclusionsDDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees.