Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults

2019 ◽  
Author(s):  
Susan C McKernan ◽  
Julie C Reynolds ◽  
Aparna Ingleshwar ◽  
Mark Pooley ◽  
Raymond A Kuthy ◽  
...  
Keyword(s):  
Low Income ◽  
Dental Care ◽  
Behavioral Model ◽  
Medicaid Expansion ◽  
Dental Services ◽  
Dental Utilization ◽  
Access To Dental Care ◽  
Transportation Barriers ◽  
General Dentist ◽  
Improve Access

This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa's Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen's behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.

Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults

2017 ◽  
Vol 3 (1) ◽  
pp. 101-108 ◽  
Author(s):  
S.C. McKernan ◽  
J.C. Reynolds ◽  
A. Ingleshwar ◽  
M. Pooley ◽  
R.A. Kuthy ◽  
...  
Keyword(s):  
Low Income ◽  
Dental Care ◽  
Behavioral Model ◽  
Medicaid Expansion ◽  
Dental Services ◽  
Dental Utilization ◽  
Access To Dental Care ◽  
Transportation Barriers ◽  
General Dentist ◽  
Improve Access

This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa’s Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen’s behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.

scholarly journals Predictors of use of dental care by children in north-central Appalachia in the USA

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0250488
Author(s):  
Cecelia I. Nelson ◽  
Casey D. Wright ◽  
Jamey T. Brumbaugh ◽  
Katherine Neiswanger ◽  
Richard J. Crout ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Care ◽  
Behavioral Model ◽  
Future Research ◽  
Dental Services ◽  
North Central ◽  
Dental Utilization ◽  
Central Appalachia ◽  
The Usa ◽  
Anxiety And Fear

Use of dental services in childhood, especially preventive care, is associated with many important oral health outcomes throughout life. The Andersen behavioral model of healthcare utilization posits that predisposing characteristics, enabling resources, and need factors predict utilization in oral and other healthcare domains. Inequities that produce lower utilization of dental services in north-central Appalachia have been documented in comparison to the USA generally. Additionally, within Appalachia, there are disparities, such as those across different states related to varying public policies and resources supporting healthcare. Predictors of dental utilization in Appalachia have been a focus in adults, but less so in children. The aim of the current study was to understand predictors of dental utilization in children in north-central Appalachia in order to inform future research about how to intervene to address these disparities. In this study, there were 1,178 children, ages 1 through 10 years, from selected representative counties in West Virginia and Pennsylvania, along with a parent/caregiver, who were part of the Center for Oral Health Research in Appalachia (COHRA1) cohort. Use of dental services by their child was indicated by parents/caregivers, who also reported on sociodemographic, dental care-related anxiety and fear, and values and attitudes associated with oral healthcare. Results indicated that use of professional dental services by children was related to child age, dental anxiety and fear, and parental oral health values and attitudes. Older children in this age group, those who evidenced more dental care-related anxiety and fear, and whose parent/caregiver placed higher value on oral health and healthcare for themselves, were more likely to have had a dental visit in the past year.

scholarly journals Teledentistry: New Tool to Access Dental Care

2019 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
Aditi Verma ◽  
Akshay Dhall ◽  
Sakshi Kataria
Keyword(s):  
Dental Care ◽  
Dental Education ◽  
Health Sector ◽  
Access To Dental Care ◽  
Improve Access

The Health sector is undergoing dramatic revolution by incorporating the utilization of computers and telecommunications. Its Implications in hospitals and among physicians have gained attention. However, its impact on dentistry is less widely reported. Teledentistry can improve access to dental care as well can be used as a tool for dental education.

Programs and Policies Targeted to Improve Access to Dental Care for Low Income Adults and Children in the US: An Integrative Literature Review

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Davis AL ◽  
◽  
Zare H ◽  
Kanwar O ◽  
McCleary R ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Literacy ◽  
Literature Review ◽  
Low Income ◽  
Dental Care ◽  
Oral Health Care ◽  
Oral Health Literacy ◽  
The Us ◽  
Access To Dental Care

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that addressed six oral health policy spheres. 1) Community-based dental access programs; (2) Medicaid reimbursement and expansion; (3) Student loan support; (4) Oral health services in non-traditional settings and dental residency programs; (5) Programs to improve oral health literacy; and (6) Use of dental therapists. Results: The authors included 39 articles for qualitative synthesis. Numerous public health initiatives and programs exist in the US aimed at increasing access to quality oral health care. Medicaid expansion, increased Medicaid fee-for-service reimbursement rates, and state loan repayment programs have demonstrated some success in improving access among underserved populations. A diversified dental workforce, with community dental health workers and mid-level providers like dental therapists, as well as interprofessional training of nurses and primary-care physicians in oral health have also shown positive impacts in advancing health equity. Further studies are needed to understand how oral health literacy programs can affect access and utilization of dental services. Conclusions: Improvements to the oral health care safety net will require a holistic and multifaceted approach in order to reduce oral health disparities. Policy levers should work, not in isolation, but rather in complementary fashion to one another.

scholarly journals Changes In Coverage And Access To Dental Care Five Years After ACA Medicaid Expansion

2020 ◽  
Vol 39 (11) ◽  
pp. 1900-1908
Author(s):  
Hawazin W. Elani ◽  
Benjamin D. Sommers ◽  
Ichiro Kawachi
Keyword(s):  
Dental Care ◽  
Medicaid Expansion ◽  
Access To Dental Care

scholarly journals Barriers of utilisation of dental services among children and adolescent: A systematic review

2018 ◽  
Vol 30 (3) ◽  
pp. 150
Author(s):  
Avlien Farlina ◽  
Diah Ayu Maharani
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Dental Care ◽  
Dental Service ◽  
Oral Diseases ◽  
Dental Services ◽  
Children And Adolescent ◽  
Care Utilisation ◽  
Economic Barriers ◽  
Low Income Families

Introduction: Underutilisation of dental services among children and adolescent is a worldwide problem that increases caries prevalence. Younger children are less likely to receive dental care and, thus, experience oral diseases more often. This systematic review was aimed to explore the barriers of utilisation of dental services among children and adolescent. Methods: The literature search was conducted in the electronic database of Pubmed©/Medline©. The literature exclusion criteria were adults and qualitative study. Keywords were verified in MeSH. Boolean “AND” and “NOT” was used to specify the search. Twenty-four literature were filtered from Pubmed©, and twenty-three literature fit the inclusion criteria. Result: The result revealed that low-income families, minority ethnic, and disability condition have lower dental care utilisation. Conclusion: The identified potential determinants of oral health and dental care utilisation among children and adolescent are economic barriers, uninsurance, and availability of dental service providers.Keywords: Dental care, dental services, utilisation, barrier, children, adolescent.

scholarly journals County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

2019 ◽  
Author(s):  
Mark E Moss ◽  
Andrew Grodner ◽  
Ananda P. Dasanayake ◽  
Cherry M. Beasley
Keyword(s):  
North Carolina ◽  
Pregnant Women ◽  
Low Income ◽  
Well Being ◽  
Economic Research ◽  
County Level ◽  
Dental Services ◽  
Dental Utilization ◽  
Persistent Poverty ◽  
Utilization Of Dental Services

Abstract Background: Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that extend beyond the dentist-patient relationship. We examined county-level data to generate hypotheses about factors that influence utilization of dental services in North Carolina’s Medicaid for Pregnant Women (MPW) program. Methods: County-level Medicaid utilization data for dental services for 2014-2016 were pooled to get mean county estimates of dental utilization in the MPW program. Descriptive statistics and multivariate regression models of dental utilization and county-level measures are presented. Data used were collected by NC Child and the Robert Wood Johnson Foundation’s County Health Rankings Reports. USDA Economic Research Service data were used to categorize counties in terms of Farming, Recreation, Persistent Poverty, and metro/non-metro status using Rural Urban Continuum Codes. Results: Dental utilization ranged from 1% to 26% with a median of 8.5% across the 100 counties of North Carolina. Strong patterns linking utilization of dental services in the MPW program to contextual social measures of well-being emerged, specifically, increased reporting of child abuse and neglect, elevated infant mortality, poor quality of life, and worse ranking in years of potential life lost. Counties with persistent poverty had lower rates of dental utilization. Conclusions: Utilization of dental services in the MPW program is generally low. Patterns identify the potential for enhancing community-clinical linkages to improve birth outcomes and care coordination for pregnant women to enhance dental utilization in this population.

scholarly journals Socioeconomic Inequalities in the Utilization of Dental Services Among Adults in Saudi Arabia

2021 ◽  
Author(s):  
Deema A. Sahab ◽  
Mohammed S. Bamashmous ◽  
Amitha Ranauta ◽  
Vanessa Muirhead
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Dental Care ◽  
Household Wealth ◽  
Socioeconomic Inequalities ◽  
Dental Services ◽  
Services Utilization ◽  
Dental Utilization ◽  
Dental Services Utilization ◽  
Utilization Of Dental Services

Abstract Background This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services. Methods In this cross-sectional study, we conducted secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires, one for the household and one individual interview. The questionnaires included questions covering predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization. The independent variables were the predisposing, enabling and need factors. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model. Results The final dataset included 8,535 adults (response rate = 95.4%). Twenty percent of adults visited the dentist at least once in the past year (95%CI: 18% -21%). The socioeconomic factors associated with the higher likelihood of dental service utilization in the final fully adjusted model were high household income (OR = 1.43, p = 0.043), second and middle household wealth status (OR = 1.51, p = 0.003 and OR = 1.57, p = 0.006) and access to free governmental health care (OR = 2.05, p = 0.004). In addition to self-reported oral problems (OR= 52.09, p < 0.001). Conclusion Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The main driver of dental services utilization in adults was the need for treatment suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.

scholarly journals County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

2020 ◽  
Author(s):  
Mark E Moss ◽  
Andrew Grodner ◽  
Ananda P. Dasanayake ◽  
Cherry M. Beasley
Keyword(s):  
North Carolina ◽  
Pregnant Women ◽  
Care Coordination ◽  
Low Income ◽  
County Level ◽  
Medicaid Program ◽  
Dental Services ◽  
Dental Utilization ◽  
Persistent Poverty ◽  
Utilization Of Dental Services

Abstract Background: Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that extend beyond the dentist-patient relationship. We examined county-level data to generate hypotheses about factors that influence utilization of dental services in North Carolina’s Medicaid for Pregnant Women (MPW) program.Methods: County-level Medicaid utilization data for dental services for 2014-2016 were pooled to get mean county estimates of dental utilization in the MPW program. Descriptive statistics and multivariate regression models of dental utilization and county-level measures are presented. Data used were collected by NC Child and the Robert Wood Johnson Foundation’s County Health Rankings Reports. USDA Economic Research Service data were used to categorize counties in terms of Farming, Recreation, Persistent Poverty, and metro/non-metro status using Rural Urban Continuum Codes.Results: Dental utilization ranged from 1% to 26% with a median of 8.5% across the 100 counties of North Carolina. Strong patterns linking utilization of dental services in the MPW program to contextual social measures of well-being emerged, specifically, increased reporting of child abuse and neglect, elevated infant mortality, poor quality of life, and worse ranking in years of potential life lost. Counties with persistent poverty had lower rates of dental utilization. Conclusions: Utilization of dental services in the MPW program is generally low. Patterns identify the potential for enhancing community-clinical linkages to improve birth outcomes and care coordination for pregnant women to enhance dental utilization in this population.Dental coverage in the Medicaid program in most states is administered separately from medical coverage. The separation of the funding mechanisms adds a further layer of complexity to care integration. Efforts to enhance dental care for pregnant women in the Medicaid program may benefit from policy that aligns incentives for care coordination within the community. Policy that extends the window of eligibility for dental benefits to 24 months after the birth of the child will help women complete the dental treatment that is needed. This also leverages the value of care coordination for community stakeholders from diverse child health sectors.

scholarly journals Access to dental care: examining the issues

2011 ◽  
Vol 93 (8) ◽  
pp. 269-269
Author(s):  
Paul Batchelor
Keyword(s):  
Dental Care ◽  
Advisory Group ◽  
Dental Practice ◽  
Research Committee ◽  
Dental Services ◽  
Department Of Health ◽  
The Us ◽  
Access To Dental Care ◽  
Care Systems ◽  
The Uk

The research committee and lay advisory group of the Faculty of General Dental Practice (UK) recently hosted a joint symposium at the College with the aim of understanding issues around access in dentistry. Access – what exactly is the problem? brought together key thinkers with a variety of expertise to give their perspective on what is meant by access and to explore where the main issues lie. Also discussed was how the Department of Health currently views these issues and how patients use dental services in the UK. Clearly, problems concerning access to healthcare are not limited to dentistry; the symposium also included perspectives from medicine and examined issues facing dental care systems overseas, specifically in the US.

Sign in / Sign up

Export Citation Format

Share Document