Effects of Pregnancy and Postpartum Medicaid Dental Benefit Generosity On Use Of Dental Services

怀孕和产后医疗补助牙科福利慷慨对使用牙科服务的影响

基本信息

批准号：
10726708
负责人：
Astha Singhal
金额：
$ 16.03万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10726708
关键词：
Accident and Emergency department Adoption American Appointment Birth Child Data Data Files Decision Making Dental Dental Care Dentists Disparity Eligibility Determination Emergency Situation Emergency department visit Enrollment Future Goals Health Healthcare Home Information Systems Knowledge Longevity Low Birth Weight Infant Low income Maternal Health Measures Medicaid Medicaid eligibility Medical Monitor Mothers Oral Oral health Outcome Parents Patient Self-Report Patients Pattern Periodontitis Physiological Policies Policy Making Postpartum Period Postpartum Women Pregnancy Pregnant Women Premature Birth Preventive Preventive dental care Qualifying Quasi-experiment Research Research Design Risk Risk Assessment Services Surveys Techniques Time Tooth Diseases Tooth Loss Variant Visit Woman administrative database cost federal policy improved insight novel post implementation pregnant prenatal programs

项目摘要

PROJECT SUMMARY The goal of this study is to examine the effects of the generosity of Medicaid dental benefits for pregnant and postpartum women on access to preventive, routine and emergent dental care. Our central hypothesis is that low-income women in states that provide comprehensive dental benefits will have a higher likelihood of preventive and routine dental care in their pregnancy, and less likely to have emergency department visits for dental problems. In addition, low-income women in states that provide dental benefits in the year after birth will have greater utilization of preventive and routine dental care. To evaluate our hypothesis, we will examine the relationships between state-level generosity of Medicaid dental benefits for pregnant women and access and utilization of dental care during pregnancy and postpartum. We will use Pregnancy Risk Assessment and Monitoring Survey (PRAMS) data on dental care use and unmet dental needs from 2012-2019; and recently released nationally representative T-MSIS Analytic Files (TAF) from 2016-2019 that captures detailed types of dental utilization among more than 5 million pregnant women in the US. Our specific aims are: Aim 1. Examine the impact of pregnancy-related Medicaid dental benefits generosity on access to preventive dental care and unmet dental need during pregnancy using a causal difference-in-differences approach; Aim 2. Measure the association between pregnancy-related Medicaid dental benefits generosity and routine and emergent dental care use during pregnancy; Aim 3. Assess the relationships between postpartum Medicaid dental benefit generosity and routine and emergent dental care use in the year after birth. We will use a combination of descriptive and quasi-experimental approaches reinforced with several robustness checks. These rigorous and comprehensive approaches will enable us to make strong, generalizable conclusions about use of dental care during pregnancy and postpartum and the impacts of generosity and duration of Medicaid dental benefits. Our study will be the first to examine ED visits for dental problems in pregnancy and the patterns of postpartum dental care use. The knowledge generated through this research will inform decision-making and implementation of postpartum extensions of pregnancy-related Medicaid eligibility under the American Rescue Plan and provide preliminary data for a subsequent R01 that examines the effects of these extensions on maternal oral health.

项目概要本研究的目的是检验慷慨的医疗补助牙科福利对孕妇和孕妇的影响。产后妇女获得预防性、常规和紧急牙科护理的机会。我们的中心假设是提供全面牙科福利的州的低收入妇女将更有可能获得怀孕期间进行预防性和常规牙科护理，并且不太可能因怀孕而去急诊室就诊牙齿问题。此外，在出生后一年内提供牙科福利的州的低收入妇女将更好地利用预防性和常规牙科护理。为了评估我们的假设，我们将检验州级慷慨的孕妇医疗补助牙科福利与获得和获得之间的关系在怀孕期间和产后利用牙科护理。我们将使用怀孕风险评估和 2012-2019 年牙科护理使用情况和未满足牙科需求的监测调查 (PRAMS) 数据；以及最近发布了 2016 年至 2019 年具有全国代表性的 T-MSIS 分析文件 (TAF)，其中捕获了详细类型美国有超过 500 万孕妇使用牙科。我们的具体目标是：目标 1. 检查与怀孕相关的医疗补助牙科福利慷慨对获得预防性牙科护理的影响和使用因果双重差异法确定怀孕期间未满足的牙科需求；目标 2. 测量怀孕相关医疗补助牙科福利慷慨与常规和紧急牙科之间的关联怀孕期间的护理使用；目标 3. 评估产后医疗补助牙科福利之间的关系出生后一年内的慷慨以及常规和紧急牙科护理的使用。我们将使用以下组合描述性和准实验方法通过多项稳健性检查得到加强。这些严谨而综合方法将使我们能够就牙科护理的使用得出强有力的、普遍的结论怀孕期间和产后以及医疗补助牙科福利的慷慨和持续时间的影响。我们的研究将是第一个检查妊娠期牙科问题和产后模式的急诊就诊的研究牙科护理用途。通过这项研究产生的知识将为决策和决策提供信息根据美国救援计划实施产后延长与怀孕相关的医疗补助资格为后续 R01 计划并提供初步数据，以检查这些扩展对产妇口腔健康。