Geographic variation of dental utilization among low income children

McKernan, Susan C.; Kuthy, Raymond A.; Hanley, Paul F.; Jones, Michael P.; Momany, Elizabeth T.; McQuistan, Michelle R.; Damiano, Peter C.

doi:10.1016/j.healthplace.2015.05.002

Cited by 16 publications

(9 citation statements)

References 23 publications

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“…The density of pediatric dentists at county (city) level is significantly related to the utilization of oral health care at county (city) level [37]. A similar finding was reported in America, where utilization of dental care showed a negative trend as urbanization decreased [38].…”

Section: Discussionmentioning

confidence: 63%

Utilization of dental services and associated factors among preschool children in China

Gao

Ding

et al. 2020

BMC Oral Health

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Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen's behavioural model to explore influencing factors, thereby providing a reference for future policy making.Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child's parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization.Results: The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6-19.4%) among 5year-old children. "No dental diseases" (71.3%) and "dental disease was not severe" (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor's degree or higher (OR: 2.29, 95%CI: 1.97-2.67, p < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p < 0.001), think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84-4.40, p < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81-12.09, p < 0.001) were more likely to go to the dentist in the past year. Conclusion:The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

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Section: Discussionmentioning

confidence: 63%

Utilization of dental services and associated factors among preschool children in China

Gao

Ding

et al. 2020

BMC Oral Health

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“…McKernan et al reported on the existence of significant geographic differences in access to dental care based on race/ethnicity after controlling for individual and service area characteristics. 3 Borrell et al reported on the possible coexistence of the Black, Hispanic, and poverty status spatially among seniors in Northern Manhattan and the South Bronx. In addition, the study identified that transportation may inhibit access to dental care for seniors who reside in the areas.…”

Section: Introductionmentioning

confidence: 99%

Geographic variations in dental sealant utilization by Medicaid enrollees

Okunseri

García

et al. 2020

J Public Health Dent

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Objective: To investigate geographical variations and their relationship to race/ ethnicity in dental sealant utilization for first molars among Wisconsin Medicaid enrollees from 2010 to 2013. Methods: Wisconsin Medicaid dental claims for sealants in children aged 6-16 years were analyzed. County-level population density, urban influence code, presence of dental health professional shortage areas, and population-per-dentist ratio were considered as geographic predictors. Descriptive statistics and mixed effects Poisson regression models were used to examine the effect of county level covariates on the number of dental sealants received per person-year (PY) of eligibility adjusting for patient-level characteristics. Over-dispersion was modeled by a random residual effect, and all models adjusted for single-year age and gender interaction and race/ethnicity main effect. Results: Medicaid claims for sealants on first permanent molars for 2010-2013 totaled 288,019 over 1,130,000 PY. The age-and gender-standardized rate of first molar sealant applications per 100 PY were 27.9, 25.7, and 16.6 for White, Hispanic, and Black children, respectively. County-specific rates ranged from a low of 8.9 per 100 PY to a high of 62.6 per 100 PY. In the multivariate analysis after adjusting for geography, compared to Whites, Hispanics had highest rates (rate ratio (RR) = 1.33, 95% CI = 1.30-1.37) of dental sealant utilization followed by Blacks (RR = 1.25, 95% CI = 1.21-1.29). Population density was the only significant geographic predictor (RR = 0.56 per 10-fold increase, 95% CI = 0.45-0.69). Conclusions: Substantial geographic variability in the utilization of sealants for first molars was identified. Lower population density was the main geographical predictor of high sealant utilization.

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“…Heterogeneity of towns were ignored as township is the smallest administrative unit in China containing its own area, geography and population. Zip code [ 48 ] and healthcare service unit [ 49 , 50 ] need to be investigated in our further study as they were selected in some previous studies. Finally, no pre-after analysis was conducted in the current study which led to the unavailability of demonstrating the effect of integration of the two kinds of health insurance on geographic variation of health insurance benefits.…”

Section: Discussionmentioning

confidence: 99%

Geographic variation in health insurance benefits in Qianjiang District, China: a cross-sectional study

Zhang

Liu

et al. 2018

Int J Equity Health

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BackgroundHealth insurance contributes to reducing the economic burden of disease and improving access to healthcare. In 2016, the Chinese government announced the integration of the New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) to reduce system segmentation. Nevertheless, it was unclear whether there would be any geographic variation in health insurance benefits if the two types of insurance were integrated. The aim of this study was to identify the potential geographic variation in health insurance benefits and the related contributing factors.MethodsThis cross-sectional study was carried out in Qianjiang District, where the NCMS and URBMI were integrated into Urban and Rural Resident Basic Medical Insurance Scheme (URRBMI) in 2010. All beneficiaries under the URRBMI were hospitalized at least once in 2013, totaling 445,254 persons and 65,877 person-times, were included in this study. Town-level data on health insurance benefits, healthcare utilization, and socioeconomic and geographical characteristics were collected through health insurance system, self-report questionnaires, and the 2014 Statistical Yearbook of Qianjiang District. A simplified Theil index at town level was calculated to measure geographic variation in health insurance benefits. Colored maps were created to visualize the variation in geographic distribution of benefits. The effects of healthcare utilization and socioeconomic and geographical characteristics on geographic variation in health insurance benefits were estimated with a multiple linear regression analysis.ResultsDifferent Theil index values were calculated for different towns, and the Theil index values for compensation by person-times and amount were 2.5028 and 1.8394 in primary healthcare institutions and 1.1466 and 0.9204 in secondary healthcare institutions. Healthcare-seeking behavior and economic factors were positively associated with health insurance benefits in compensation by person-times significantly, meanwhile, geographical accessibility and economic factors had positive effects (p < 0.05).ConclusionsThe geographic variation in health insurance benefits widely existed in Qianjiang District and the distribution of health insurance benefits for insured inpatients in primary healthcare institutions was distinctly different from that in secondary healthcare institutions. When combining the NRCM and URMIS in China, the geographical accessibility, healthcare-seeking behavior and economic factors required significant attention.

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Geographic variation of dental utilization among low income children

Cited by 16 publications

References 23 publications

Utilization of dental services and associated factors among preschool children in China

Utilization of dental services and associated factors among preschool children in China

Geographic variations in dental sealant utilization by Medicaid enrollees

Geographic variation in health insurance benefits in Qianjiang District, China: a cross-sectional study

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