Assessing contribution of the dental care system to oral health care disparities

评估牙科保健系统对口腔保健差异的贡献

• 批准号: 7586295
• 负责人: Nadereh Pourat
• 金额: $ 12.41万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7586295
• 关键词: Address; Area; Caring; Categories; Characteristics; Child; Clinic; Communities; Data; Databases; Dental; Dental Care; Dental Care Delivery; Dental Insurance; Dental Staff; Dentists; Disadvantaged; Education; Elderly; Employment; Fees; Funding; Geographic Locations; Goals; Health Professional; Health Services Accessibility; Human Resources; Improve Access; Individual; Insurance; Length; Link; Location; Logistic Regressions; Low income; Measures; Medical; Modeling; Numbers; Oral health; Play; Policies; Population; Private Practice; Provider; Range; Research; Role; Services; Socioeconomic Factors; Socioeconomic Status; Solutions; Subgroup; Surveys; System; Time; Underserved Population; Visit; base; cost; design; discount; falls; health disparity; innovation; population survey; programs; racial and ethnic

DESCRIPTION (provided by applicant): Limited access to dental care exacerbates oral health care disparities in underserved populations. The barriers in access at the individual level have been explored to a large extent; however, the impact of the dental care system on access is poorly understood. Reduced access has been linked to a lower overall supply of dentists, but little is known about the relationship between the specific characteristics of dental providers, such as education and practice setting, and access. The specific aims of this project are: 1) to assess the impact of dentist characteristics on access to dental care of underserved populations; and 2) to assess the potential differences in impact of dentist characteristics on specific categories of the underserved, such as children, low- income, and racial/ethnic populations. Using Andersen's conceptual framework of access to care, it is hypothesized that access to dental care is influenced by the context in which dental care is delivered, or the dental care system, in addition to individual characteristics. Measures of the dental care system are primarily conceptualized as personal and practice characteristics of dentists in the medical study service area where individuals reside. The data for this study include an existing population-based survey of individuals, an existing representative survey of dentists in private practice, and existing administrative data. The dependent variables (length of time since last dental visit and unmet dental care) and individual level independent variables will be obtained from the population survey. Independent variables measuring personal and practice characteristics of dentists will be obtained from the dentist survey. Examples of the latter measures are percentages of private practice dentists in the medical study service area who accept discounted fees, participate in public insurance programs, or have large practices (as indicated by number of various personnel and multiple practice locations). Additional independent variables on supply or availability of other dental care providers will be obtained from administrative data (e.g. designation of dental health professional shortage area, number of visits to community-based clinics). The impact of dentist characteristics on access will be examined in multinomial and dichotomous logistic regression models, controlling for individual and other predictors of access to dental care. Both models will be stratified by subgroups of underserved populations to assess potential differences in predictors of access among groups. Improving access to dental care is the solution most likely to reduce observed disparities in oral health of underserved populations. Research that identifies systemic barriers in access to care of the underserved populations is needed to inform policies designed to diminish oral health disparities. Project Narrative: Relevance Statement Improving access to dental care is the solution most likely to reduce observed disparities in oral health of underserved populations. Research that identifies systemic barriers in access to care of the underserved populations is needed to inform policies designed to diminish oral health disparities.

描述（由申请人提供）：有限的牙科保健加剧了口腔保健的差距，在服务不足的人群。在很大程度上探讨了在个人层面上获得的障碍，但是，牙齿护理系统对获得的影响知之甚少。减少访问已链接到牙医的整体供应量较低，但很少有人知道牙科服务提供者的具体特征，如教育和实践环境，和访问之间的关系。该项目的具体目标是：1）评估牙医特征对服务不足人群获得牙科护理的影响; 2）评估牙医特征对服务不足人群（如儿童、低收入和种族/民族人群）的影响的潜在差异。使用安德森的概念框架，获得护理，它是假设，获得牙科保健的影响的背景下，提供牙科保健，或牙科保健系统，除了个人特征。牙科保健系统的措施主要是概念化的个人和实践特征的牙医在医疗研究服务领域的个人居住。本研究的数据包括现有的基于人口的个人调查，现有的私人执业牙医的代表性调查，以及现有的行政数据。将从人群调查中获得因变量（自上次牙科就诊以来的时间长度和未满足的牙科护理）和个体水平自变量。测量牙医的个人和实践特征的自变量将从牙医调查中获得。后一种措施的例子是在医学研究服务领域接受折扣费用，参加公共保险计划或拥有大型实践（如各种人员和多个实践地点的数量所示）的私人执业牙医的百分比。关于其他牙科保健提供者的供应或可用性的其他自变量将从行政数据中获得（例如，指定牙科保健专业人员短缺地区，社区诊所的就诊次数）。牙医特征对访问的影响将在多项和二分逻辑回归模型中进行检查，控制个人和其他获得牙科保健的预测因素。两个模型都将按服务不足人群的亚组进行分层，以评估各组之间获得服务的预测因素的潜在差异。改善获得牙科保健的机会是最有可能减少服务不足人口口腔健康差距的解决方案。需要进行研究，以确定在获得服务不足的人群获得护理方面的系统性障碍，从而为旨在减少口腔健康差距的政策提供信息。项目叙述：相关性声明改善获得牙科保健的机会是最有可能减少服务不足人群口腔健康差异的解决方案。需要进行研究，以确定在获得服务不足的人群获得护理方面的系统性障碍，从而为旨在减少口腔健康差距的政策提供信息。