Access to Dental Care Flashcards
what does “access” mean?
that ppl can get the dental care they need when they want it
*it is a complex, multidisciplinary concept
what is more likely to happen if ppl can access healthcare?
- receive basic preventitive services and edu
- oral diseases detected earlier
what are the current delivery systems of dental care?
- private practice
- hospital dentistry
- public programs
access to dental care is typically assessed by measuring what?
- number of ppl w dental visits
- number who are uninsured
- those who identify dental care as an unmet need
*self-reported insurance data, however, tend to overestimate dental visits and insurance coverage
what % of the US pop had a dental visit in the last year?
65% (majority private practice)
*35% not receiving at least one visit annually
what % of children ages 2-17 had a dental visit in the last year?
83%
what % of adults ages 18-64 had a dental visit in the past year?
61.7%
what % of adults ages 65 and over had a dental visit in the last year?
60.6%
what was the most commonly identified unmet health care need for ohio children regardless of income?
dental care
*prescription drugs were a close second
what groups have the majority of access problems?
- low SES and working poor
- minority groups (ethnic and racial)
- elderly and very young
- special needs and medically compromised
- institutionalized
- rural/run-down areas
what are the disparities for untreated caries based on ethnicity?
white kids = 26%
AA kids = 36%
Hispanic kids = 43%
American indian or native american = 69%
what are the disparities for untreated caries based on income?
- income greater than 200% FPL = 30.7%
- income greater than 100 but less than 200 = 45.2%
- income less than 100 % FPL = 55.3%
what is the dentist to patient ratio that gives an adequate enough number to establish a practice?
1 to 1,507
have the areas of shortage of dentists in ohio risen or fallen in recent years?
risen (we need more dentists)
what are the 2 major reasons people do not visit the dentist
- they lack insurance and cannot afford care
- they do not perceive the need for dental care unless there is pain or an infection
what does federal law require for all states in regards to dental benefits?
must have dental benefits for kids in medicaid programs
- not the same for adults
- 35% of children in medicaid programs received dental services in 2009
why is it such an issue that ppl with medicaid coverage cannot have the care they need?
shortage of dentist wanting to participate in medicaid programs
because of:
-low reimbursement rates, paperwork, failed appts, time consuming and complex, disruptive behavior
when do dental benefit levels for medicaid pts increase the most?
only when state officials are sued by advocates for poor ppl
what is the difference in health care received by kids in medicaid as opposed to no insurance at all?
medicaid is only 10% higher than uninsured
what are potential barriers to medicaid pts getting care?
- lack of preparation of dentists to treat children, elderly, and those with special needs
- private dentists more likely to practice in urban metropolitan areas with a high proportion of middle and higher income residents than in rural areas
how many dental visits to the emergency dept were there from 2010-2011?
100,000
- higher rate of utilization among NH blacks
- most visits by pts who were uninsured or had private coverage
*over 58 million dollars
when did most dental patients visit the ED?
on the weekdays (69%)
what are the strategies to improve access?
- the pipeline, professions, and practive program
- initial funding of programs in 15 dental schools
- focus in recruitment of minority applicants, curricular changes to prepare students to care for underserved pops
how long has New Zealand had a dental therapist program?
more than 75 years
*alaska is also considering this idea
what is the DHAT scope of practice?
- all ages
- supervised provider
- part of a TEAM of dental and medical providers
what is the schooling for dental therapists in minnesota?
-four year, baccalureate program to train dental therapists and establishes a two-year master’s program for advanced dental therapists
is there sufficient evidence that introduction of dental therapists will improve access to care?
no
with the health care reform act, is access getting better or worse?
millions of children have become eligible for medicaid
