Oral Health Disparities in Publicly Insured Children

描述（由申请人提供）：本申请是通过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，必要的培训和指导，以发展成为一个独立的研究者。申请人在研究和学术牙科方面有既定的承诺和兴趣记录。问题：在这个国家，特别是低收入儿童和有特殊保健需要的儿童，在获得牙科保健方面存在很大差距。目的：本项目调查目前在北卡罗莱纳州和弗吉尼亚州参加公共保险项目的儿童（1-18岁）在获得牙科保健和儿科口腔保健方面的差异。方法：北卡罗莱纳州（NC）的公共保险牙科计划（医疗补助/SCHIP）作为按服务收费的计划进行管理，而弗吉尼亚州（VA）的公共保险儿童在管理护理组织和按服务收费的牙科计划中注册。该项目将研究医疗保健组织因素的影响，如管理式医疗与按服务收费计划的对比，以及计划绩效指标对儿童口腔健康结果的差异。目的：第一项研究将描述注册动态和获得牙科服务超过三年期间（2001-2003）在两个州的公共保险儿童。第二项研究将检查这三年期间儿童牙科计划的执行情况（利用、预防的有效性和质量）。第三项研究将检查1-5岁儿童在医院使用与传统牙科设置的可能性。第四项研究是一项可行性研究，旨在探讨口腔健康个案管理在医学领域的临床意义。益处：这种定量技术和临床研究的结合将用于解决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.