ADULT MEDICAID PATIENTS' DENTAL VISITS IN EDS

EDS 中成人医疗补助患者的牙科就诊

基本信息

批准号：
2885650
负责人：
LEONARD A COHEN
金额：
$ 13.99万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-07-01 至 2001-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2885650
关键词：
Medicare /Medicaid adult human (21+) dental disorder dental health services emergency health services health care cost /financing health care policy health care service utilization health services research tag hospital utilization human data

项目摘要

Broad Objective: To evaluate adult Maryland Medicaid patients' patterns of use of hospital emergency departments (EDs) for the treatment of mouth pain and infections associated with teeth and periodontal tissues. Additionally, changes in the frequency of ED dental visits resulting from the elimination of adult Medicaid reimbursement to dentists for the treatment of dental emergencies will be examined. Rationale: Pain from toothaches represents a significant public health problem. The poor and minorities who lack access to private dental services may utilize EDs for the treatment of these and related conditions. EDs generally lack dental services, and thus, are usually not capable of providing definitive treatment for oral conditions. Specific Aims: 1 - To determine the rate with which Medicaid patients visited hospital emergency departments (EDs) for the treatment of mouth pain and infections associated with the teeth and periodontal tissues in Maryland from February 1990 to February 1996; 2. To determine whether the rate of visits changed after the institution of a policy (in February of 1993) to eliminate Medicaid reimbursement for emergency visits to dentists' offices; 3. To determine projections of the cost savings from reduced dental office visits and any resulting cost shifting from increased ED visits for the periods before and after the policy revision. Research Design: This study examines the use of EDs, during the six-year period February 16, 1990 to February 15, 1996, for the treatment of mouth pain and infections associated with the teeth and periodontal tissues. The study employs an observational quasi- experimental design with two study groups defined as follows: adult Medicaid patients using the ED for dental problems prior to February 16, 1993 and adult Medicaid patients using the ED for dental problems after February 15, 1993. The study employs a natural experiment, the change in Medicaid policy which eliminated dentist reimbursement, to establish the two study periods. Data tapes describing Medicaid patients use of EDs will be obtained from the Medicaid Management Information System which is maintained by the Maryland Department of Health and Mental Hygiene. This system includes a claims database from which dental related visits can be identified (based on ICD-9-CM Codes) and costs can be quantified. It also includes recipient files from which the total number of person-years of coverage can be quantified. Using these sources of information, it will be possible to calculate the number and cost of dental related ED visits per person-year of Medicaid eligibility both before February 16, 1993 and after February 15, 1993. Descriptive and inferential statistical methods will be used to analyze the data.

广泛的目标：评估成年马里兰州医疗补助患者的使用模式医院急诊科（EDS）治疗与牙齿和牙周组织相关的口腔疼痛和感染。此外，将检查由于消除成人医疗补助报销给牙医治疗牙齿紧急情况而导致的ED牙科访问频率的变化。理由：牙痛的疼痛代表了一个重大的公共卫生问题。无法获得私人牙科服务的贫困和少数民族可以利用EDS来治疗这些及其相关条件。 EDS通常缺乏牙科服务，因此通常无法为口服条件提供明确的治疗方法。具体目的：1-确定医疗补助患者从1990年2月至1996年2月，医疗补助患者访问医院急诊室（EDS）治疗与马里兰州牙齿和牙周组织相关的感染率； 2。确定政策制定后（1993年2月）以消除医疗补助偿还牙医办公室的紧急访问后是否发生了变化； 3。确定减少牙科办公室访问的成本节省的预测以及在政策修订前后的急诊室访问增加而产生的任何成本转移。研究设计：本研究研究了EDS的使用，在1990年2月16日至1996年2月15日的六年期间，用于治疗与牙齿和牙周组织相关的口腔疼痛和感染。该研究采用观察性的实验设计，由两个研究组定义为：成人医疗补助患者在1993年2月16日之前使用ED解决牙科问题，而成人医疗补助患者则在1993年2月15日之后使用ED进行牙科问题。该研究采用了自然实验，一项自然实验，医疗补助政策的变化，消除了牙科阶段的研究，以建立两次研究期间，以建立两项研究。描述医疗补助患者使用EDS的数据录像带将从马里兰州卫生和精神卫生部维护的医疗补助管理信息系统中获得。该系统包括一个索赔数据库，可以从中识别与牙科相关的访问（基于ICD-9-CM代码），并且可以量化成本。它还包括接收者文件，可以从中量化承保范围的总数。使用这些信息来源，可以计算1993年2月16日和1993年2月15日之后的每个人年度医疗补助资格的相关牙科访问的数量和成本。描述性和推论统计方法将用于分析数据。