The role of comprehensive adult Medicaid dental benefit in improving oral health and reducing disparities among adults and children

成人医疗补助综合牙科福利在改善口腔健康和减少成人与儿童之间的差异方面的作用

基本信息

批准号：
10740009
负责人：
Shillpa Naavaal
金额：
$ 16.61万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
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：
2023-09-19 至 2028-08-31
项目状态：
未结题

项目摘要

The Role of Comprehensive Adult Medicaid Dental Benefit in Improving Oral Health and Reducing Disparities among Adults and Children Project Summary Even though it is well established that oral health is integral to overall health, economic productivity, and well- being, it remains the most common unmet health need in the US. Low-income and minority groups carry a significantly high burden of dental disease, highlighting socioeconomic disparities and lack of access to oral health care. A large proportion of these groups rely on Medicaid, but unlike children, federal law does not mandate dental coverage for adults, and coverage varies by state leaving many uninsured or underinsured. Starting July 2021, Virginia expanded dental coverage for all Medicaid-enrolled adults (up to 138% of FPL), providing access to comprehensive dental care to thousands of adults for the first time. This dental policy change provides a unique opportunity, a 'natural experiment,' to gain a deeper and clear understanding of the effect of implementing a comprehensive dental benefit on the oral health of Medicaid enrollees and fill a critical gap in oral health services research. The purpose of the proposed K08 research project is to evaluate the role of Virginia's comprehensive adult Medicaid dental policy on dental care utilization and reducing oral health disparities among the Medicaid population. The project will: 1) examine the demand for dental services among Medicaid-enrolled adults following the implementation of the dental benefit, 2) evaluate the impact of dental benefit on the use of the emergency department (ED) for dental visits by comparing adults enrolled in Medicaid with those having private insurance, and 3) assess the effect of the Medicaid adult dental benefit on children's dental care use. Data sources will include multi-year claims data from the Virginia Medicaid program and Virginia All Payers Claims Data that will be linked with the county-level workforce and community data on social factors from multiple sources. Causal inference methods and advanced econometric and data science approaches such as difference-in-difference and interrupted time series will be used to isolate the policy's effect on measured oral health outcomes. The primary goal of this K08 application is to advance the candidate's (Dr. Naavaal) research career by protecting her time to acquire training in health policy, econometrics, and data science and gain research experience in applying these methods to conduct rigorous oral health services and health policy research. This goal will be accomplished through executing proposed research supported by carefully planned training objectives and intensive career development activities. The proposed research outcomes will generate the evidence needed to inform strategies to strengthen existing and new policies, including systems-level changes needed to minimize disparities and maximize oral health gains. The expertise and guidance of the multi-disciplinary mentoring and advisory teams, in addition to the wealth of resources and commitment to training provided through the institutional environment, will ensure the success of the candidate's research project and enable her to establish a robust research program as an independent research investigator.

综合成人医疗补助牙齿益处在改善口腔健康和减少的作用成人和儿童之间的差异项目摘要即使可以很好地确定口腔健康是整体健康，经济生产力和良好的不可或缺的一部分存在，它仍然是美国最常见的未满足健康需求。低收入和少数群体携带牙齿疾病的负担很高，强调社会经济差异和缺乏口服的机会卫生保健。这些小组中很大一部分依赖医疗补助，但与儿童不同，联邦法律不依赖医疗补助成人的授权牙齿覆盖范围，覆盖范围因国家而造成许多未保险或保险不足的状态。从2021年7月开始，弗吉尼亚州扩大了所有医疗补助成年人的牙科覆盖范围（最高占FPL的138％），首次为成千上万的成年人提供综合牙科护理。这项牙科政策变更提供了一个独特的机会，一个“自然实验”，以更深入，清晰地了解实施全面的牙科福利对医疗补助注册人口腔健康的影响并填补关键口腔健康服务研究中的差距。拟议的K08研究项目的目的是评估角色弗吉尼亚州综合的成人医疗补助牙科牙科政策有关牙科护理利用和降低口腔健康医疗补助人群之间的差异。该项目将：1）检查对牙科服务的需求实施牙科福利后，以医疗补助注册的成年人，2）评估牙齿的影响通过比较参加Medicaid的成年人的急诊科（ED）进行牙科探访的好处与拥有私人保险的人，以及3）评估医疗补助成人牙科福利对儿童的影响牙科护理使用。数据来源将包括弗吉尼亚医疗补助计划的多年索赔数据，弗吉尼亚州所有付款人都要求将其与县级劳动力和社区数据联系起来的数据来自多个来源的社会因素。因果推理方法以及发达计算和数据科学诸如差异差异和中断时间序列之类的方法将用于隔离政策的对测量口腔健康结果的影响。该K08应用的主要目标是促进候选人（Naavaal博士）研究职业，通过保护她获得健康政策培训的时间，计量经济学和数据科学并获得了应用这些方法进行严格的研究经验口腔卫生服务和卫生政策研究。这个目标将通过执行提议来实现仔细计划的培训目标和密集的职业发展活动支持的研究。这拟议的研究结果将为加强现有的策略提供所需的证据，并新政策，包括最大程度地减少差异并最大化口服健康增长所需的系统级别的变化。除了财富之外，多学科指导和咨询团队的专业知识和指导资源和对通过机构环境提供的培训的承诺将确保成功候选人的研究项目，使她能够建立一个强大的研究计划研究调查员。