DENTAL AND ORTHODONTIC ACCESS IN CRANIOFACIAL CARE

描述(由申请人提供)：有特殊健康护理需要的儿童获得牙科护理的能力是一个研究不足的领域。对于患有颅面部疾病的儿童来说，获得牙科和正畸护理特别重要，因为这些儿童需要牙科和正畸护理，这是其健康状况的直接结果，也是其重建治疗的重要组成部分。这项研究的总体目标是开发工具，以确定获得牙科和正畸护理的障碍的头面部疾病患者，并确定潜在的战略，通过这些战略可以改善获得护理的机会。考虑到这一点，提出了四个具体目标。在第一个项目中，将利用从关键线人对患者和家属的访谈中获得的信息来开发工具，以确定和描述为患有颅面部疾病的儿童获得及时和适当的牙科和正畸护理的障碍。在第二个项目中，华盛顿州医疗补助索赔数据将被分析，以表征牙齿和正畸护理的利用率以及为患有唇裂和/或腭裂的低收入儿童提供护理的旅行距离。将确定华盛顿州患有颅面部疾病的医疗补助受益人难以获得当地牙科/正畸护理的地区。在第三个项目中，将开展一项全州范围的调查，以评估社区正畸医生目前在照顾患有头面部疾病的儿童方面的参与程度，并确定可能促进或阻碍未来更多参与的因素。在最后一个项目中，将确定患者倡导方案的模式，并发展法学院和颅面中心之间的合作，目标是制定一个倡导方案，旨在改善患有头面部疾病的儿童获得牙科和正畸护理的机会。在这一规划授权期结束时，我们将准备实施一项大规模评估，以确定获得牙科和正畸护理的障碍及其后果，以及专门针对我们确定的障碍的干预项目。随后的全面项目的首要目标将是改善获得牙科和正畸护理的机会，从而促进所有患有头面部疾病的儿童的最佳结果。这一模式可能适用于其他州的儿童和其他有特殊卫生保健需求的儿童群体。

DESCRIPTION (provided by applicant): The ability of children with special health care needs to access dental care is an understudied area. Access to dental and orthodontic care for children with craniofacial disorders is of particular importance since these children require dental and orthodontic care as a direct result of their medical condition and as an essential part of their reconstructive treatment. The overall objectives of this study are to develop tools to characterize barriers to accessing dental and orthodontic care for patients with craniofacial disorders and to identify potential strategies by which access to care may be improved. With that in mind, four specific aims are proposed. In the first project, instruments will be developed, using information obtained from key informant interviews of patients and families, to identify and characterize barriers to accessing timely and appropriate dental and orthodontic care for children with craniofacial disorders. In the second project, Washington state Medicaid claims data will be analyzed to characterize dental and orthodontic care utilization and travel distance for care for low-income children with cleft lip and/or palate. Areas of Washington State where Medicaid beneficiaries with craniofacial disorders have difficulty accessing local dental/orthodontic care will be identified. In the third project, a statewide survey will be developed to assess current level of involvement of community orthodontists in caring for children with craniofacial disorders and to identify factors that could potentially promote or impede increased participation in the future. In the final project, models of patient advocacy programs will be identified and collaborations between the Law School and the Craniofacial Center will be developed with the goal of developing an advocacy program aimed at improving access to dental and orthodontic care for children with craniofacial disorders. At the completion of this planning grant period, we will be prepared to implement a large scale assessment to characterize barriers to accessing dental and orthodontic care and their consequences, as well as intervention projects specifically targeted at the barriers we identify. The overarching goal of the subsequent full-scale project will be to improve access to dental and orthodontic care and thus promote optimal outcomes for all children with craniofacial disorders. This model could potentially be applied to children in other states and to other groups of children with special health care needs.