Oral Health Disparities in Publicly Insured Children

描述（由申请人提供）：此申请是通过NIDCR学者发展和教师过渡奖的教师过渡阶段获得NIH职业奖。该申请提出了一个全面的跨学科计划，提供必要的培训和指导，以发展成为一名独立的调查员。申请人在牙科研究和学术方面有着既定的承诺和兴趣记录。问题：在这个国家，特别是对低收入儿童和有特殊医疗保健需求的儿童，在获得牙科保健方面存在显著差异。目的：该项目调查了北卡罗来纳州和弗吉尼亚州目前存在的公共保险计划中为儿童（1-18岁）提供的口腔保健和儿科绩效指标的差异。研究方法：北卡罗来纳州的公共保险牙科计划（医疗补助/SCHIP）是作为收费服务计划管理的，而弗吉尼亚州的公共保险儿童参加了管理式护理组织和收费服务牙科计划。该项目将研究医疗保健组织因素的影响，如管理式护理与收费服务计划和计划绩效指标对儿科口腔健康结果的差异。目的：第一项研究将描述两个州的公共保险儿童在三年期间（2001-2003年）的注册和获得牙科服务的动态。第二项研究将审查这三年期间儿童牙科计划的绩效（利用率、预防效果和质量）。第三项研究将检查1-5岁入组儿童住院使用与传统牙科设置的可能性。第四项研究是一个可行性项目，旨在探讨口腔健康个案管理在医疗竞技场的临床意义。优点：这种定量技术和临床研究的组合将用于解决NIDCR消除口腔健康差异的优先研究领域。

DESCRIPTION (provided by applicant): This application is for a NIH Career Award through the Faculty Transition Phase of the NIDCR Scholar Development and Faculty Transition Award. This application proposes a comprehensive interdisciplinary program of necessary training and mentorship to develop into an independent investigator. The applicant has an established record of commitment and interest in research and academic dentistry. Problem: There are significant disparities in access to dental care in this country, particularly for low-income children and those with special health care needs. Purpose: This project investigates disparities in access to dental care and pediatric performance measures of oral health care provided to children (1-18 years) enrolled in public insurance programs that currently exist in North Carolina and Virginia. Methods: North Carolina's (NC) public insurance dental plans (Medicaid/SCHIP) are administered as fee-for-service programs, while Virginia's (VA) publicly insured children are enrolled in both managed care organizations and fee-for-service dental programs. This project will examine the impact of health care organizational factors such as managed care versus fee-for-service programs and the difference in plan performance measures on pediatric oral health outcomes. Aims: The first study will describe the dynamics of enrollment and the access to dental services over a three-year period (2001-2003) of publicly insured children in both states. The second study will examine the performance of dental plans (utilization, effectiveness of prevention and quality) for children over this three-year period. The third study will examine the likelihood of hospital use versus the conventional dental setting for enrolled children 1-5 years of age. The fourth study is a feasibility project aimed at exploring the clinical implications of oral health case management in the medical arena. Benefit: This mix of quantitative techniques and a clinical study will be utilized to address the NIDCR Priority Research Area of eliminating oral health disparities.