scholarly journals The Effect of Dental Insurance on the Use of Dental Care for Older Adults: A Partial Identification Analysis

2014 ◽  
Vol 24 (7) ◽  
pp. 840-858 ◽  
Author(s):  
Brent Kreider ◽  
Richard J. Manski ◽  
John Moeller ◽  
John Pepper
Author(s):  
Nam-Hee Kim ◽  
Se-Hwan Jung ◽  
Ichiro Kawachi

The Korean National Health Insurance extended its coverage to reduce the economic burden of receiving dentures and implants for older adults in 2012 and 2014, respectively. We examined whether the new policy resulted in reduced out-of-pocket dental care expenditure in the eligible population, specifically focusing on low-income adults. We used interrupted time-series analysis (ITSA), a quasi-experimental design, to identify the effects of the policy among persons aged 65 or older. Data were extracted from the Korea Health Panel Survey (KHP; 2008–2017). The main outcome was out-of-pocket expenditures on dental care. The ITSA showed that expenditures decreased annually by 4.5% (RR: 0.96, 95% CI: 0.95–0.96) between 2012 and 2014. However, expenditure increased by 7.8% (RR: 1.08, 95% CI: 1.07–1.08) after 2014. Dental insurance coverage did not contribute to reducing the out-of-pocket expenses for dentures among low-income adults, while coverage of dental implants led to an increase in dental expenditure.


2021 ◽  
pp. 002203452110190
Author(s):  
C.D. Meyerhoefer ◽  
J.V. Pepper ◽  
R.J. Manski ◽  
J.F. Moeller

Past research suggests there are systematic associations between oral health and chronic illness among older adults. Although causality has not yet been credibly established, periodontitis has been found to be associated with higher risk of both heart disease and stroke. We advance this literature by estimating the direct association between dental care use and systemic health using multiple waves of the 1992 to 2016 Health and Retirement Study. Through the inclusion of individual fixed effects in our regression models, we account for unobservable time-invariant characteristics of individuals that might otherwise bias estimates of the association between dental care use and health. We find statistically significant negative associations between dental care use and the number of health conditions, self-reported overall health, the incidence of heart disease, and the incidence of stroke. In particular, the use of dental care within the past 2 y is associated with a 2.7% reduction in the likelihood of being diagnosed with a heart condition and a reduction in the likelihood of a stroke diagnosis of between 5.3% and 11.6%. We also find large positive correlations between edentulism and the measures of chronic illness. Associations from models estimated separately for men and women are qualitatively similar to one another. These findings provide additional motivation for the consideration of a Medicare dental benefit.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.


2020 ◽  
Vol 152 ◽  
pp. S437
Author(s):  
E. Watson ◽  
W. Xu ◽  
M. Giuliani ◽  
J. Huang ◽  
S. Huang ◽  
...  

2021 ◽  
Author(s):  
Yan Luo

BACKGROUND The depression level among US adults significantly increased during the Coronavirus Disease 2019 (COVID-19) pandemic and age disparity in depression during the pandemic were reported in recent studies. Delay or avoidance of medical care is one of the collateral damages caused by the COVID-19 pandemic and it can lead to increased morbidity and mortality. OBJECTIVE The present study aims to assess the prevalence of depression and delay of care among US middle-aged adults and older adults during the pandemic, as well as investigate the role of delay of care in depression among those two age groups. METHODS This cross-sectional study used the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0) data. Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years old were included. Depression was measured by Composite International Diagnostic Interview Short Form (CIDI-SF). Delay of care were measured by four items: delay of surgery, delay of seeing a doctor, delay of dental care, and delay of other care. Univariate analyses, bivariate analyses, and binary logistic regression were conducted. RESULTS More than half of participants were older than 65 years old (58.23%) and 274 participants (8.75%) had depression during the pandemic. Delay of dental care was positively associated with depression among both middle-aged adults (OR=2.05, 95%CI=1.04-4.03, P<0.05) and older adults (OR=3.08, 95%CI=1.07-8.87, P<0.05). Delay of surgery was positively associated with depression among older adults (OR=3.69, 95%CI=1.06-12.90, P<0.05). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education level (some college of above) or worse self-reported health had higher likelihood to have depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults. CONCLUSIONS This study found that depression among middle-aged and older adults during the pandemic was also prevalent. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the effect of delay of surgery and dental care on depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients’ concern on delay of surgery and dental care. Moreover, the implementation of tele-mental health services is also needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive CLINICALTRIAL N/A


Author(s):  
Mary E. Northridge ◽  
Ivette Estrada ◽  
Eric W. Schrimshaw ◽  
Ariel P. Greenblatt ◽  
Sara S. Metcalf ◽  
...  

2019 ◽  
Vol 32 (7-8) ◽  
pp. 744-752 ◽  
Author(s):  
Sae Hwang Han ◽  
Bei Wu ◽  
Jeffrey A. Burr

Objective: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults. Method: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline ( N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years. Results: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline. Discussion: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures.


2020 ◽  
Vol 32 (10) ◽  
pp. 1387-1398
Author(s):  
Kenzie Latham-Mintus ◽  
Ashley Vowels ◽  
Swapnali Chavan

Objectives: This research examines whether perceived neighborhood disorder influences the use of preventive healthcare services (i.e. influenza vaccine, pneumonia vaccine, cholesterol screening, colonoscopy, and dental care) by older adults and whether social ties buffer the potential adverse effects of perceived neighborhood disorder. Methods: Using data from the 2012 wave of the Health and Retirement Study, binary logistic regression was used to generate odds ratio estimates of preventive healthcare use in the past 2 years. Results: We find that greater levels of neighborhood disorder were associated with fewer dental care visits net of social and health factors. Regular participation in four or more social activities was associated with decreased odds of restricted use and increased odds of receiving a pneumonia vaccine and colonoscopy. Discussion: This research provides evidence that perceived neighborhood disorder may act as a barrier for specific preventive healthcare services and highlights the need for targeted intervention.


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