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ADULT MEDICAID PATIENTS' DENTAL VISITS IN EDS

EDS 中成人医疗补助患者的牙科就诊

基本信息

批准号：
2885650
负责人：
LEONARD A COHEN
金额：
$ 13.99万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-07-01 至 2001-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2885650
关键词：
Medicare /Medicaid adult human (21+) dental disorder dental health services emergency health services health care cost /financing health care policy health care service utilization health services research tag hospital utilization human data

项目摘要

Broad Objective: To evaluate adult Maryland Medicaid patients' patterns of use of hospital emergency departments (EDs) for the treatment of mouth pain and infections associated with teeth and periodontal tissues. Additionally, changes in the frequency of ED dental visits resulting from the elimination of adult Medicaid reimbursement to dentists for the treatment of dental emergencies will be examined. Rationale: Pain from toothaches represents a significant public health problem. The poor and minorities who lack access to private dental services may utilize EDs for the treatment of these and related conditions. EDs generally lack dental services, and thus, are usually not capable of providing definitive treatment for oral conditions. Specific Aims: 1 - To determine the rate with which Medicaid patients visited hospital emergency departments (EDs) for the treatment of mouth pain and infections associated with the teeth and periodontal tissues in Maryland from February 1990 to February 1996; 2. To determine whether the rate of visits changed after the institution of a policy (in February of 1993) to eliminate Medicaid reimbursement for emergency visits to dentists' offices; 3. To determine projections of the cost savings from reduced dental office visits and any resulting cost shifting from increased ED visits for the periods before and after the policy revision. Research Design: This study examines the use of EDs, during the six-year period February 16, 1990 to February 15, 1996, for the treatment of mouth pain and infections associated with the teeth and periodontal tissues. The study employs an observational quasi- experimental design with two study groups defined as follows: adult Medicaid patients using the ED for dental problems prior to February 16, 1993 and adult Medicaid patients using the ED for dental problems after February 15, 1993. The study employs a natural experiment, the change in Medicaid policy which eliminated dentist reimbursement, to establish the two study periods. Data tapes describing Medicaid patients use of EDs will be obtained from the Medicaid Management Information System which is maintained by the Maryland Department of Health and Mental Hygiene. This system includes a claims database from which dental related visits can be identified (based on ICD-9-CM Codes) and costs can be quantified. It also includes recipient files from which the total number of person-years of coverage can be quantified. Using these sources of information, it will be possible to calculate the number and cost of dental related ED visits per person-year of Medicaid eligibility both before February 16, 1993 and after February 15, 1993. Descriptive and inferential statistical methods will be used to analyze the data.

总体目的：评估马里兰州医疗补助计划（Medicaid）成年患者在医院急诊科（EDs）治疗与牙齿和牙周组织相关的口腔疼痛和感染的模式。此外，由于取消了成人医疗补助计划对牙医治疗牙科紧急情况的报销，ED牙科就诊频率的变化将被检查。理由：牙痛是一个严重的公共健康问题。穷人和少数民族谁无法获得私人牙科服务可以利用急诊科治疗这些和相关的条件。急诊科通常缺乏牙科服务，因此，通常不能为口腔疾病提供明确的治疗。具体目的：1 -确定1990年2月至1996年2月，马里兰州医疗补助计划患者因口腔疼痛和与牙齿和牙周组织相关的感染而前往医院急诊科（EDs）治疗的比率；2. 确定在一项政策（1993年2月）取消医疗补助计划对牙医诊所紧急就诊的报销后，就诊率是否发生了变化；3. 在政策修订前后，预测因减少牙科诊所就诊而节省的费用，以及因增加急诊科就诊而产生的费用转移。研究设计：本研究调查了在1990年2月16日至1996年2月15日的六年间，ed治疗与牙齿和牙周组织相关的口腔疼痛和感染的使用情况。本研究采用观察性准实验设计，分为两组：1993年2月16日之前使用急诊科治疗牙齿问题的成年医疗补助患者和1993年2月15日之后使用急诊科治疗牙齿问题的成年医疗补助患者。该研究采用了一个自然实验，即医疗补助政策的变化，取消了牙医的报销，来建立两个研究时期。描述医疗补助患者使用急诊科的数据磁带将从医疗补助管理信息系统获得，该系统由马里兰州健康和心理卫生部维护。该系统包括一个索赔数据库，可以从中识别与牙科相关的就诊（基于ICD-9-CM代码），并可以量化费用。它还包括接收者文件，从中可以量化覆盖的总人数-年。利用这些信息来源，可以计算出1993年2月16日之前和1993年2月15日之后医疗补助资格的人均年牙科相关急诊科就诊次数和费用。将使用描述性和推断性统计方法来分析数据。