Effects of Pregnancy and Postpartum Medicaid Dental Benefit Generosity On Use Of Dental Services

项目总结 这项研究的目标是检查慷慨的医疗补助牙科福利对孕妇和 产后妇女获得预防性、常规和紧急牙科护理的机会。我们的中心假设是 在提供全面牙科福利的州，低收入女性将有更高的可能性 在怀孕期间进行预防性和常规的牙科护理，不太可能因以下原因去急诊科就诊 牙齿有问题。此外，在提供出生后一年牙科福利的州，低收入妇女将 更好地利用预防性和常规的牙科护理。为了评估我们的假设，我们将检查 州一级对孕妇的医疗补助牙科福利慷慨程度与可获得性和 孕期和产后牙科保健利用情况。我们将使用怀孕风险评估和 2012-2019年牙科保健使用和未满足的牙科需求的监测调查(PRMS)数据；以及最近 2016-2019年发布的具有全国代表性的T-MSIS分析文件(TAF)，其中捕获了 美国500多万名孕妇的牙齿利用情况。我们的具体目标是：目标1.考试 与怀孕相关的医疗补助牙科福利慷慨对获得预防性牙科保健和 在怀孕期间未满足的牙科需求使用因果性差异方法；目标2。测量 妊娠相关医疗补助牙科福利慷慨与常规牙科和急诊牙科的关系 孕期护理使用；目标3.评估产后医疗补助牙科福利之间的关系 在出生后的第二年，慷慨和常规的和紧急的牙齿护理使用。我们将结合使用 描述性和准实验方法通过几个稳健性检查得到加强。这些严谨和 综合的方法将使我们能够就牙科保健的使用得出强有力的、可概括的结论 在怀孕期间和产后，以及医疗补助牙科福利的慷慨程度和持续时间的影响。我们的 这项研究将首次检查孕期牙科问题的急诊室就诊情况和产后的模式 牙科护理用途。通过这项研究产生的知识将为决策和 美国援救计划下产后延长妊娠相关医疗补助资格的实施 为随后的R01计划并提供初步数据，该R01将检查这些扩展对 产妇口腔健康。

PROJECT SUMMARY The goal of this study is to examine the effects of the generosity of Medicaid dental benefits for pregnant and postpartum women on access to preventive, routine and emergent dental care. Our central hypothesis is that low-income women in states that provide comprehensive dental benefits will have a higher likelihood of preventive and routine dental care in their pregnancy, and less likely to have emergency department visits for dental problems. In addition, low-income women in states that provide dental benefits in the year after birth will have greater utilization of preventive and routine dental care. To evaluate our hypothesis, we will examine the relationships between state-level generosity of Medicaid dental benefits for pregnant women and access and utilization of dental care during pregnancy and postpartum. We will use Pregnancy Risk Assessment and Monitoring Survey (PRAMS) data on dental care use and unmet dental needs from 2012-2019; and recently released nationally representative T-MSIS Analytic Files (TAF) from 2016-2019 that captures detailed types of dental utilization among more than 5 million pregnant women in the US. Our specific aims are: Aim 1. Examine the impact of pregnancy-related Medicaid dental benefits generosity on access to preventive dental care and unmet dental need during pregnancy using a causal difference-in-differences approach; Aim 2. Measure the association between pregnancy-related Medicaid dental benefits generosity and routine and emergent dental care use during pregnancy; Aim 3. Assess the relationships between postpartum Medicaid dental benefit generosity and routine and emergent dental care use in the year after birth. We will use a combination of descriptive and quasi-experimental approaches reinforced with several robustness checks. These rigorous and comprehensive approaches will enable us to make strong, generalizable conclusions about use of dental care during pregnancy and postpartum and the impacts of generosity and duration of Medicaid dental benefits. Our study will be the first to examine ED visits for dental problems in pregnancy and the patterns of postpartum dental care use. The knowledge generated through this research will inform decision-making and implementation of postpartum extensions of pregnancy-related Medicaid eligibility under the American Rescue Plan and provide preliminary data for a subsequent R01 that examines the effects of these extensions on maternal oral health.