The role of comprehensive adult Medicaid dental benefit in improving oral health and reducing disparities among adults and children

成人医疗补助综合牙科福利在改善口腔健康和减少成人与儿童之间的差异方面的作用

• 批准号: 10740009
• 负责人: Shillpa Naavaal
• 金额: $ 16.61万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740009
• 关键词: Accident and Emergency department; Address; Adult; Advisory Committees; Child; Child Health; Clinical Investigator Award; Communities; Complex; Comprehensive Dental Care; County; Data; Data Science; Data Set; Data Sources; Dental; Dental Care; Dental Care for Children; Dental Scaling; Development; Development Plans; Disparity; Economics; Emergency Situation; Emergency department visit; Enrollment; Ensure; Environment; Ethnic Origin; Face; Family; Foundations; Goals; Health; Health Benefit; Health Disparities Research; Health Policy; Health Services; Health Services Accessibility; Health Services Research; Healthcare; Individual; Institution; Insurance; Interruption; K-Series Research Career Programs; Knowledge; Laws; Link; Low income; Measures; Medicaid; Mentors; Mentorship; Methods; Minority Groups; Mouth Diseases; National Institute of Dental and Craniofacial Research; Natural experiment; Oral health; Outcome; Outcomes Research; Parents; Personal Satisfaction; Policies; Policy Research; Population; Preventive; Preventive service; Privatization; Productivity; Quasi-experiment; Race; Research; Research Personnel; Research Project Grants; Research Support; Resources; Role; Rural; Savings; Series; Service delivery model; Services; Solid; Source; State Children' s Health Insurance Program; Structure; System; Time; Tooth Diseases; Training; Underinsured; Uninsured; Virginia; Vision; Visit; Work; access disparities; analytical method; career; career development; complex data; cost; disparity reduction; econometrics; ethnic minority; evidence base; experience; federal poverty level; health disparity; health equity; health inequalities; improved; insight; multidisciplinary; programs; racial minority; service utilization; skill acquisition; skills; social factors; socioeconomic disparity; success; treatment services

The Role of Comprehensive Adult Medicaid Dental Benefit in Improving Oral Health and Reducing Disparities among Adults and Children Project Summary Even though it is well established that oral health is integral to overall health, economic productivity, and well- being, it remains the most common unmet health need in the US. Low-income and minority groups carry a significantly high burden of dental disease, highlighting socioeconomic disparities and lack of access to oral health care. A large proportion of these groups rely on Medicaid, but unlike children, federal law does not mandate dental coverage for adults, and coverage varies by state leaving many uninsured or underinsured. Starting July 2021, Virginia expanded dental coverage for all Medicaid-enrolled adults (up to 138% of FPL), providing access to comprehensive dental care to thousands of adults for the first time. This dental policy change provides a unique opportunity, a 'natural experiment,' to gain a deeper and clear understanding of the effect of implementing a comprehensive dental benefit on the oral health of Medicaid enrollees and fill a critical gap in oral health services research. The purpose of the proposed K08 research project is to evaluate the role of Virginia's comprehensive adult Medicaid dental policy on dental care utilization and reducing oral health disparities among the Medicaid population. The project will: 1) examine the demand for dental services among Medicaid-enrolled adults following the implementation of the dental benefit, 2) evaluate the impact of dental benefit on the use of the emergency department (ED) for dental visits by comparing adults enrolled in Medicaid with those having private insurance, and 3) assess the effect of the Medicaid adult dental benefit on children's dental care use. Data sources will include multi-year claims data from the Virginia Medicaid program and Virginia All Payers Claims Data that will be linked with the county-level workforce and community data on social factors from multiple sources. Causal inference methods and advanced econometric and data science approaches such as difference-in-difference and interrupted time series will be used to isolate the policy's effect on measured oral health outcomes. The primary goal of this K08 application is to advance the candidate's (Dr. Naavaal) research career by protecting her time to acquire training in health policy, econometrics, and data science and gain research experience in applying these methods to conduct rigorous oral health services and health policy research. This goal will be accomplished through executing proposed research supported by carefully planned training objectives and intensive career development activities. The proposed research outcomes will generate the evidence needed to inform strategies to strengthen existing and new policies, including systems-level changes needed to minimize disparities and maximize oral health gains. The expertise and guidance of the multi-disciplinary mentoring and advisory teams, in addition to the wealth of resources and commitment to training provided through the institutional environment, will ensure the success of the candidate's research project and enable her to establish a robust research program as an independent research investigator.

综合成人医疗补助牙科福利在改善口腔健康和减少