A comparative analysis of public and private dental benefit payer types for the provision and outcomes of root canal therapy on permanent teeth of children and adolescents in Massachusetts.
A comparative analysis of public and private dental benefit payer types for the provision and outcomes of root canal therapy on permanent teeth of children and adolescents in Massachusetts.
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DOI：
10.1016/j.adaj.2022.10.011
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发表时间：
2023-02
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影响因子：
--
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中科院分区：
文献类型：
--
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尽管美国儿童和青少年的牙科福利大幅增加，牙科服务的使用也有所改善，但根据牙科保险付款人类型的口腔健康差异仍然存在。作者使用全付款人索赔（2013-2017）数据库，根据牙科保险付款人类型，对 6 至 18 岁儿童恒牙的牙髓手术（根管治疗）的提供和治疗结果进行了比较分析。在人和牙齿水平上进行了统计分析，包括逻辑回归、Cox 比例风险回归和 Kaplan-Meier 方法。与私人保险儿童和青少年相比，公共付费儿童和青少年受益人在研究期间更有可能接受根管治疗（调整后优势比，1.91；95% CI，1.73至2.11），并且与该手术相关的治疗结果较差（调整后风险比，2.19；95% CI，1.53至3.14；P < .0001）期间。参加私人保险的人更有可能接受牙髓病医生（提供根管治疗的专家）的治疗（P < .0001）。对于私人付款人来说，保险公司允许和支付的金额明显更高 (P < .001)。私人和公共保险儿童和青少年之间的牙髓治疗的提供和结果存在显着差异。尽管表面上获得护理的机会平等，但私人和公共保险患者之间在提供口腔保健方面存在差异。这些差异可能导致口腔健康状况持续存在差异。
Despite substantial increases in dental benefits and improvements in the use of dental services among children and adolescents in the United States, oral health disparities according to dental insurance payer type persist. The authors used an all-payer claims (2013-2017) database to perform a comparative analysis of the provision and treatment outcomes of an endodontic procedure (root canal therapy) in the permanent teeth of a pediatric population aged 6 through 18 years, according to dental insurance payer type. Statistical analyses, including logistic regression, Cox proportional hazards regression, and the Kaplan-Meier method, were performed at person and tooth levels. Compared with privately insured children and adolescents, public-payer children and adolescent beneficiaries were more likely to have had root canal therapy (adjusted odds ratio, 1.91; 95% CI, 1.73 to 2.11) and had poorer treatment outcomes associated with the procedure (adjusted hazard ratio, 2.19; 95% CI, 1.53 to 3.14; P < .0001) during the study period. Those enrolled in private insurance were more likely to receive treatment from an endodontist (specialist in providing root canal therapy) (P < .0001). Amounts allowed and paid by the insurer were significantly higher for private payers (P < .001). There were significant differences in the provision and outcomes of endodontic treatment between privately and publicly insured children and adolescents. Despite ostensibly equal access to care, differences in the provision of oral health care exist between privately and publicly insured patients. These differences may be contributing to persisting oral health disparities.
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DOI：
10.14219/jada.archive.2013.0117
发表时间：
2013-03
期刊：
Journal of the American Dental Association (1939)
影响因子：
--
作者：
Hom JM;Lee JY;Silverman J;Casamassimo PS
通讯作者：
Casamassimo PS
影响因子：
2.3
作者：
Bhagavatula, Pradeep;Xiang, Qun;Okunseri, Christopher
通讯作者：
Okunseri, Christopher
影响因子：
3.7
作者：
Buchmueller, Thomas C.;Orzol, Sean;Shore-Sheppard, Lara D.
通讯作者：
Shore-Sheppard, Lara D.
影响因子：
9.7
作者：
Shariff, Jaffer A.;Edelstein, Burton L.
通讯作者：
Edelstein, Burton L.
影响因子：
3.9
作者：
Nasseh, Kamyar;Fosse, Chelsea;Vujicic, Marko
通讯作者：
Vujicic, Marko