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口腔疾病方面的作用 成人和儿童之间的差异 项目概要 尽管众所周知，口腔健康是整体健康、经济生产力和良好生活不可或缺的一部分。 尽管如此，它仍然是美国最常见的未满足的健康需求。低收入群体和少数群体 牙科疾病负担非常高，凸显了社会经济差异和缺乏获得口腔服务的机会 卫生保健。这些群体中很大一部分依赖医疗补助，但与儿童不同的是，联邦法律没有规定 强制规定成年人有牙科保险，而且各州的保险范围有所不同，导致许多人没有保险或保险不足。 从 2021 年 7 月开始，弗吉尼亚州扩大了所有参加医疗补助的成年人的牙科保险范围（高达 FPL 的 138%）， 首次为数千名成年人提供全面的牙科护理服务。这项牙科政策 变革提供了一个独特的机会，一个“自然实验”，可以更深入、更清晰地理解 实施全面的牙科福利对医疗补助参与者口腔健康的影响并填补了关键 口腔保健服务研究方面的差距。拟议的 K08 研究项目的目的是评估其作用 弗吉尼亚州关于牙科护理利用和减少口腔健康的综合成人医疗补助牙科政策 医疗补助人口之间的差异。该项目将： 1) 检查人们对牙科服务的需求 实施牙科福利后加入医疗补助的成年人，2) 评估牙科福利的影响 通过比较参加医疗补助计划的成年人，了解使用急诊科 (ED) 进行牙科就诊的好处 与那些拥有私人保险的人一起，以及 3) 评估医疗补助成人牙科福利对儿童的影响 牙科护理用途。数据源将包括来自弗吉尼亚州医疗补助计划的多年索赔数据和 弗吉尼亚州所有付款人索赔数据将与县级劳动力和社区数据相关联 来自多种来源的社会因素。因果推理方法以及先进的计量经济学和数据科学 将使用双重差分和中断时间序列等方法来隔离政策的 对测量的口腔健康结果的影响。该 K08 应用程序的主要目标是推进 通过保护候选人（Naavaal 博士）的研究生涯，保护她获得卫生政策培训的时间， 计量经济学和数据科学，并获得应用这些方法进行严格的研究经验 口腔保健服务和卫生政策研究。这一目标将通过执行拟议的 研究由精心规划的培训目标和密集的职业发展活动支持。这 拟议的研究成果将产生所需的证据，为加强现有和 新政策，包括最小化差异和最大化口腔健康收益所需的系统级变革。 多学科指导和咨询团队的专业知识和指导，以及丰富的经验 通过制度环境提供的资源和对培训的承诺将确保成功 候选人的研究项目，使她能够作为独立的人建立一个强大的研究计划 研究调查员。