Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

促进儿童口腔健康：确定与医疗办公室提供氟化物清漆相关的提供者、实践和社区层面的特征

• 批准号: 10668989
• 负责人: Ashley Kranz
• 金额: $ 35.33万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-14 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668989
• 关键词: Affect; Attitude; Belief; Big Data; Caregivers; Cessation of life; Characteristics; Child; Child Health; Childhood; Communities; Control Groups; Cost Sharing; Data; Data Set; Deductibles; Dental; Dental Care; Dental caries; Dentists; Disease; Eligibility Determination; Emergency department visit; Environment; Fluoride Varnishes; Future; Health; Health Benefit; Health Care Reform; Health Insurance; Health Services; Healthy People 2020; Hospitalization; Insurance Carriers; Interview; Massachusetts; Medicaid; Medical; Methods; Oral health; Pain; Patient Self-Report; Patients; Policies; Preventive; Preventive service; Privatization; Provider; Quality of life; Recommendation; Research; Research Personnel; Risk; Schools; Services; Socioeconomic Status; Statutes and Laws; Surveys; Training; United States Preventative Services Task Force; Visit; Well Child Visits; Work; aged; contextual factors; cost; health plan; improved; informant; medical examination; medical specialties; pediatrician; prevent; primary care provider; programs; provider behavior; rurality

Project Summary Tooth decay is preventable, yet costly. Spending on dental treatment for children totaled $8.7 billion in 2013— making it the fifth most costly child health condition. Preventive oral health services, like fluoride varnish, can prevent tooth decay in young children. However, fewer than 50% of children have an annual dental visit, likely due to cost, dentists’ reluctance to treat young children, and dental workforce shortages. To increase use of preventive oral health services, private health plans and all state Medicaid programs now cover delivery of fluoride varnish in medical offices to all children younger than 6 years. Existing evidence indicates that delivery of fluoride varnish in medical offices increases utilization and reduces decay in publicly insured children. Despite these benefits, few children receive fluoride varnish in medical offices. In 2014, only 5% of eligible children received this service in Massachusetts. Prior studies to identify barriers and strategies have focused on publicly insured children and relied on self-reported provider information, thus a new “big data” approach is needed to identify provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices. Our mixed-methods study will use Massachusetts All Payer Claims Dataset, which includes both medical and dental claims for publicly and privately insured children, to (1) describe children receiving preventive oral health services, (2) estimate the causal impact of mandatory medical coverage on children’s receipt of preventive oral health services, (3) examine the mechanisms affecting delivery of preventive oral health services in medical offices, and (4) use a qualitative positive deviance approach to identify strategies and contextual factors promoting or deterring medical providers’ delivery of preventive oral health services.

项目总结