Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

Jones, Emily; Shi, Leiyu; Hayashi, A. Seiji; Sharma, Ravi; Daly, Charles A.; Ngo‐Metzger, Quyen

doi:10.2105/ajph.2012.300846

Cited by 51 publications

(36 citation statements)

References 8 publications

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“…Individuals who were female, married, native speakers, living in a metropolitan statistical area, and with dental insurance were also associated with increased utilization of general dental care. Although we studied different populations and different time periods, our results mirrored those of previous researches documenting striking racial/ethnic disparities in access to dental health care [13,[25][26][27], except one study conducted by Jones and her colleagues in 2013, using the 2009 Health Center Patient Survey [21]. They examined utilization, unmet need, and satisfaction with oral health services among Federally Qualified Health Center patients, and found no racial or ethnic disparities in access to oral health care.…”

Section: Discussionsupporting

confidence: 80%

“…On the other hand, among the ample evidences in the evaluations of US adults showing a significant gap between non-Hispanic whites and other racial/ethnic groups [17][18][19], most of these studies, however, concentrated only on generalized health care services, and evidences on dental care services were either limited or based on summary statistics. There have been studies even suggesting that minorities may in fact have similar or better access to care relative to non-Hispanic whites [9,[20][21].…”

Section: Introductionmentioning

confidence: 99%

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Racial/Ethnic Disparity in Utilization of General Dental Care Services Among US Adults: Medical Expenditure Panel Survey 2012

Zhang

2015

J. Racial and Ethnic Health Disparities

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Objective The objective of this study was to examine racial/ ethnic disparity and associated factors in general dental care utilization among US adults. Methods Data were adults 18-85 years old (N = 27,394) from the 2012 Medical Expenditure Panel Survey (MEPS). The outcome was the receipt of general dental care, measured by (1) whether the individual has ever had a general dental visit and (2) the number of general dental visits the individual has had during the past year. Race/ethnicity was the primary interest. Logistic regressions and negative binomial regressions were conducted using STATA version 12 to assess the effect of race/ethnicity on the receipt of general dental care both independently and adjusted for other demographic and socioeconomic factors. Results Non-Hispanic blacks (odds ratio (OR) 0.39, 95 % confidence intervals (CI) 0.37-0.43), Hispanics (0.34, 0.43-0.37), and other minorities (0.61, 0.56-0.68) were less likely to report general dental visits both independently and adjusted for other demographic and socioeconomic factors, compared with non-Hispanic whites. General dental visits were more likely to be observed among individuals who were female, married, native speakers, living in a metropolitan statistical area, and with dental insurance, and the number of visits was increasing with age, educational level, and family income. Conclusion The race/ethnicity disparity in the utilization of general dental care still existed. Policy makers and dental care providers should promote dental insurance coverage and language support programs, and increase the diversity of dental professionals among minorities to encourage their visits to dentists.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Racial/Ethnic Disparity in Utilization of General Dental Care Services Among US Adults: Medical Expenditure Panel Survey 2012

Zhang

2015

J. Racial and Ethnic Health Disparities

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“…19,20 Investigators in a recent study found that there were no racial or ethnic disparities in dental care utilization among FQHC patients, suggesting that these facilities may function as a critical access point to oral health services in disadvantaged communities. 21 The federal statute under which FQHCs receive grants requires all of these facilities to provide preventive dental services either on site or by means of referral. According to the American Dental Association, 22 75 percent of FQHCs provided on-site dental services in 2009.…”

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confidence: 99%

Community factors predicting dental care utilization among older adults

Lee¹,

Kim²,

Albert³

et al. 2014

The Journal of the American Dental Association

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Background Few investigators have studied the influence of community factors on dental care utilization among older adults. The authors’ objective in this study was to investigate the effect of community factors on dental care utilization after adjustment for individual factors. Methods Using data from a cross-sectional survey of Ohio residents, the authors assessed dental care utilization in a sample of 2,166 adults aged 65 years or older. They linked individual-level dental care utilization, predisposing factors (age, sex, race or ethnicity, marital status, education), enabling factors (poverty, dental insurance) and need-related factors (physical and mental health problems) with county-level data (socioeconomic environment and health resource environment) from the 2010 Area Health Resource Files (from the U.S. Department of Health and Human Services) and the American Community Survey (from the 2006–2010 U.S. Census). Using multilevel logistic regression models, the authors evaluated the association between dental care utilization and community factors after adjustment for individual factors. Results The results indicated that individual factors such as being female, married and nonpoor and having a higher educational level and private dental insurance were associated with higher odds of having utilized dental care. Furthermore, older adults living in a county with a higher dentist-to-population ratio were more likely to use dental services even after the authors adjusted the results for the individual-level factors (odds ratio = 1.10, P = .03). Conclusions County-level dentist-to-population ratio has independent effects on older adults’ dental care utilization even after adjustment for individual-level characteristics. Practical Implications A comprehensive policy plan is required to intervene at both the individual and community levels to improve dental care utilization among older adults. By understating the factors influencing dental care utilization among older adults, U.S. dentists will be better positioned to meet the dental needs of this population.

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“…38 Although 75 percent of the funded health centers provided some on-site dental care, many have multiple sites and do not necessarily provide dental services at all locations. 39 Future studies should examine whether the centers reduce dental ED visits among Medicaid beneficiaries in areas where the supply of dental providers, particularly those who accept Medicaid, is low.…”

Section: Discussionmentioning

confidence: 99%

Medicaid Dental Coverage Alone May Not Lower Rates Of Dental Emergency Department Visits

et al. 2015

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Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers.

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Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

Abstract: These results underscore the critical role that health centers play in national efforts to improve oral health status and eliminate disparities in access to timely and appropriate dental services.

Cited by 51 publications

References 8 publications

Racial/Ethnic Disparity in Utilization of General Dental Care Services Among US Adults: Medical Expenditure Panel Survey 2012

Racial/Ethnic Disparity in Utilization of General Dental Care Services Among US Adults: Medical Expenditure Panel Survey 2012

Community factors predicting dental care utilization among older adults

Medicaid Dental Coverage Alone May Not Lower Rates Of Dental Emergency Department Visits

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