Impact of Dental Care Access on Children's Oral Health and Academic Outcomes

获得牙科护理对儿童口腔健康和学业成绩的影响

基本信息

批准号：
10041658
负责人：
Brandy Lipton
金额：
$ 15.05万
依托单位：
SAN DIEGO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-05 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10041658
关键词：
Academic achievement Accident and Emergency department Adult Affect Characteristics Child Child Health Childhood Data Set Data Sources Databases Dental Dental Care Dental caries Dentists Development Emergency department visit Ethnic Origin Fluoride Varnishes Fostering Foundations Health Health Services Accessibility Health Status Income Individual Investments Learning Link Literature Longitudinal Studies Low income Measures Medicaid Methods Mission Modeling National Health and Nutrition Examination Survey National Institute of Dental and Craniofacial Research National Longitudinal Survey of Youth Natural experiment Nursery Schools Oral health Outcome Outcome Measure Parents Patient Self-Report Performance Period Analysis Pit and Fissure Sealants Policies Primary Health Care Productivity Race Records Reporting Research Research Design Research Support Role Schools Services Strategic Planning Subgroup Surveys Testing Time Time trend Tooth structure Variant Visit Work achievement test age group base care providers cognitive skill cohort design disparity reduction early childhood experience health disparity health plan human capital improved interest kindergarten novel oral condition payment public health insurance sex skills theories young adult

项目摘要

PROJECT SUMMARY/ABSTRACT Poor oral health in childhood is correlated with more school absences and lower academic achievement. There is evidence to suggest that state-level Medicaid policies, including payment rates to dentists, adult dental coverage, and coverage of fluoride varnish (FV) application by non-dentist primary care providers, have meaningful effects on the likelihood that low-income children receive recommended dental services. However, little research has linked specific Medicaid policies that increase dental care access to measures of child oral health, and further, no rigorous, large-scale studies with plausibly causal research designs have examined the connection between these policies and academic performance. There is a critical need for rigorous evidence on the potential for state-level policies to achieve improvements in these outcomes. This proposal will provide novel evidence on the link between dental care access and measures of oral health and academic performance using a natural experiment design that leverages state-level variation in Medicaid payment rates to dentists, adult dental coverage, and FV policies during 1999-2016 and large-scale national datasets that include exam-based and administrative outcome measures. Our study period captures a substantial number of state-level changes while also representing a relatively recent time frame. Our analysis will also assess important subgroup differences by child sex, age group, and race and ethnicity. In Aim 1, we will examine the link between each policy and oral health measures including the parent-reported condition of teeth from the National Survey of Children’s Health (NSCH), exam-based objective measures of untreated caries and the presence of dental sealants from the National Health and Nutrition Examination Survey (NHANES), and administrative records of emergency department visits for oral conditions from the State Emergency Department Databases (SEDD). In Aim 2, we will assess the connection between each policy and academic outcomes including school absences, school contacts with parents, parental concern about learning pre-school skills, and grade retention from the NSCH, Peabody Individual Achievement Test scores and grade retention from the National Longitudinal Survey of Youth – Child and Young Adult Cohort (CNLSY), and school absences from the Early Childhood Longitudinal Study – Kindergarten Cohort (ECLS-K). This will be the first national study to estimate the plausibly causal link between increased access to dental care and academic performance among low-income children. This research will provide critical, timely, and policy-relevant new evidence on the effects of increased access to dental care and the role for public health insurance policy.

项目概要/摘要儿童时期口腔健康状况不佳与缺课率和学业成绩较低有关。有证据表明州级医疗补助政策，包括牙医的支付率、成人牙科覆盖率以及非牙医初级保健提供者应用氟化物清漆 (FV) 的覆盖率，对低收入儿童接受推荐的牙科服务的可能性产生有意义的影响但是，很少有研究将增加牙科护理机会的具体医疗补助政策与儿童口腔措施联系起来健康，而且，还没有进行严格的、大规模的、具有合理因果研究设计的研究来检验这些政策与学业成绩之间的联系迫切需要严格的证据。该提案将提供国家级政策改善这些成果的潜力。关于牙科护理的获取与口腔健康和学术衡量标准之间联系的新证据使用自然实验设计，利用医疗补助支付率的州级差异来提高性能 1999-2016 年期间的牙医、成人牙科保险和 FV 政策以及大规模国家数据集包括基于考试和管理结果的衡量标准。我们的分析也将评估州一级的变化，同时也代表相对较新的时间范围。在目标 1 中，我们将研究按儿童性别、年龄组以及种族和民族划分的重要亚组差异。每项政策与口腔健康措施之间的联系，包括家长报告的牙齿状况全国儿童健康调查 (NSCH)，基于检查的未经治疗龋齿的客观测量和是否存在来自国家健康和营养检查调查 (NHANES) 的牙科密封剂，以及国家紧急状态下急诊科就诊口腔疾病的管理记录在目标 2 中，我们将评估每项政策与学术之间的联系。结果包括学校缺勤、学校与家长的联系、家长对学前学习的担忧来自 NSCH、皮博迪个人成就测试分数和成绩保留的技能和成绩保留来自全国青少年纵向调查——儿童和青少年队列 (CNLSY) 和学校早期儿童纵向研究 – 幼儿园队列 (ECLS-K) 中的缺席这将是第一次。一项全国性研究，旨在估计增加获得牙科护理的机会与学业之间似乎存在的因果关系这项研究将提供关键、及时且与政策相关的新信息。关于增加获得牙科护理的机会的影响以及公共健康保险政策的作用的证据。