Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

促进儿童口腔健康：确定与医疗办公室提供氟化物清漆相关的提供者、实践和社区层面的特征

• 批准号: 10238830
• 负责人: Ashley Kranz
• 金额: $ 45.68万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-14 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10238830
• 关键词: Advisory Committees; Affect; Attitude; Belief; Big Data; Caregivers; Cessation of life; Characteristics; Child; Child Health; Childhood; Communities; Control Groups; Cost Sharing; Data; Data Set; Deductibles; Dental; Dental Care; Dental caries; Dentists; Disease; Emergency department visit; Environment; Fluoride Varnishes; Future; Health; Health Benefit; Health Care Reform; Health Insurance; Health Services; Healthy People 2020; Hospitalization; Insurance Carriers; Interview; Massachusetts; Medicaid; Medical; Methods; Oral health; Pain; Patient Self-Report; Patients; Policies; Preventive; Preventive service; Privatization; Provider; Quality of life; Research; Research Personnel; Risk; Schools; Services; Socioeconomic Status; Statutes and Laws; Surveys; Training; Visit; Well Child Visits; Work; aged; care providers; contextual factors; cost; deviant; health plan; improved; informant; medical specialties; pediatrician; prevent; programs; provider behavior; rurality

Project Summary Tooth decay is preventable, yet costly. Spending on dental treatment for children totaled $8.7 billion in 2013— making it the fifth most costly child health condition. Preventive oral health services, like fluoride varnish, can prevent tooth decay in young children. However, fewer than 50% of children have an annual dental visit, likely due to cost, dentists’ reluctance to treat young children, and dental workforce shortages. To increase use of preventive oral health services, private health plans and all state Medicaid programs now cover delivery of fluoride varnish in medical offices to all children younger than 6 years. Existing evidence indicates that delivery of fluoride varnish in medical offices increases utilization and reduces decay in publicly insured children. Despite these benefits, few children receive fluoride varnish in medical offices. In 2014, only 5% of eligible children received this service in Massachusetts. Prior studies to identify barriers and strategies have focused on publicly insured children and relied on self-reported provider information, thus a new “big data” approach is needed to identify provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices. Our mixed-methods study will use Massachusetts All Payer Claims Dataset, which includes both medical and dental claims for publicly and privately insured children, to (1) describe children receiving preventive oral health services, (2) estimate the causal impact of mandatory medical coverage on children’s receipt of preventive oral health services, (3) examine the mechanisms affecting delivery of preventive oral health services in medical offices, and (4) use a qualitative positive deviance approach to identify strategies and contextual factors promoting or deterring medical providers’ delivery of preventive oral health services.

项目摘要 牙齿衰减是可以预防的，但昂贵。 使其成为第五昂贵的儿童健康状况。 但是，幼儿的蛀牙。 由于成本，牙医不愿信任幼儿，而牙科劳动力则不足以增加使用的使用。 预防性口腔健康服务，私人健康计划和所有州医疗补助计划现在涵盖交付 所有6岁以下儿童的医疗办公室氟化物清漆。 医疗办公室中的氟化物清漆可增加利用率，并减少被保险儿童出版物的腐烂。 尽管有这些好处，但很少有儿童在2014年接受氟化物清漆。 孩子们在马萨诸塞州接受了服务。 关于公开保险的孩子并依靠自我报告的提供者信息，因此，一种新的“大数据”方法是 需要确定提供者，实践，社区和政策级别的因素，以深情地交付氟化物清漆 在医疗办公室。 公开和私人保险儿童的医疗和牙科索赔，以（1）描述接受的儿童 预防性口腔卫生服务，（2）估计强制性医疗对儿童的因果影响 收到预防措施口腔卫生服务，（3）检查预防口服的感情的机制 医疗办公室的卫生服务，以及（4）使用定性的积极偏差方法来识别策略 以及促进或阻止医疗提供者提供预防性口腔健康服务的上下文因素。