Trends in use of dental care provider types and services in the United States in 2000-2016: Rural-urban comparisons.
Dental care providers
dental services
rural-urban disparity
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
03
02
2020
revised:
29
04
2020
accepted:
30
04
2020
entrez:
29
7
2020
pubmed:
29
7
2020
medline:
14
8
2020
Statut:
ppublish
Résumé
The authors conducted a study to assess recent trends in dental care provider mix (type of dental professionals visited) and service mix (types of dental procedures) use in the United States and to assess rural-urban disparities. Data were from the 2000 through 2016 Medical Expenditure Panel Survey. The sample was limited to respondents who reported at least 1 dental visit to a dental professional in the survey year (N = 138,734 adults ≥ 18 years). The authors estimated rates of visiting 3 dental professionals and undergoing 5 dental procedures and assessed the time trends by rural-urban residence and variation within rural areas. Multiple logistic regression was used to assess the association between rural and urban residence and service and provider mix. A decreasing trend was observed in visiting a general dentist, and an increasing trend was observed in visiting a dental hygienist for both urban and rural residents (trend P values < .001). An increasing trend in having preventive procedures and a decreasing trend in having restorative and oral surgery procedures were observed only for urban residents (trend P values < .001). The combined data for 2000 through 2016 showed that rural residents were less likely to receive diagnostic services (adjusted odds ratio [AOR], 0.82; 95% confidence interval [CI], 0.72 to 0.93) and preventive services (AOR, 0.87; 95% CI, 0.78 to 0.96), and more likely to receive restorative (AOR, 1.11; 95% CI, 1.02 to 1.21) and oral surgery services (AOR, 1.23; 95% CI, 1.11 to 1.37). Although preventive dental services increased while surgical procedures decreased from 2000 through 2016 in the United States, significant oral health care disparities were found between rural and urban residents. These results of this study may help inform future initiatives to improve oral health in underserved communities. By understanding the types of providers visited and dental services received, US dentists will be better positioned to meet their patients' oral health needs.
Sections du résumé
BACKGROUND
The authors conducted a study to assess recent trends in dental care provider mix (type of dental professionals visited) and service mix (types of dental procedures) use in the United States and to assess rural-urban disparities.
METHODS
Data were from the 2000 through 2016 Medical Expenditure Panel Survey. The sample was limited to respondents who reported at least 1 dental visit to a dental professional in the survey year (N = 138,734 adults ≥ 18 years). The authors estimated rates of visiting 3 dental professionals and undergoing 5 dental procedures and assessed the time trends by rural-urban residence and variation within rural areas. Multiple logistic regression was used to assess the association between rural and urban residence and service and provider mix.
RESULTS
A decreasing trend was observed in visiting a general dentist, and an increasing trend was observed in visiting a dental hygienist for both urban and rural residents (trend P values < .001). An increasing trend in having preventive procedures and a decreasing trend in having restorative and oral surgery procedures were observed only for urban residents (trend P values < .001). The combined data for 2000 through 2016 showed that rural residents were less likely to receive diagnostic services (adjusted odds ratio [AOR], 0.82; 95% confidence interval [CI], 0.72 to 0.93) and preventive services (AOR, 0.87; 95% CI, 0.78 to 0.96), and more likely to receive restorative (AOR, 1.11; 95% CI, 1.02 to 1.21) and oral surgery services (AOR, 1.23; 95% CI, 1.11 to 1.37).
CONCLUSIONS
Although preventive dental services increased while surgical procedures decreased from 2000 through 2016 in the United States, significant oral health care disparities were found between rural and urban residents.
PRACTICAL IMPLICATIONS
These results of this study may help inform future initiatives to improve oral health in underserved communities. By understanding the types of providers visited and dental services received, US dentists will be better positioned to meet their patients' oral health needs.
Identifiants
pubmed: 32718489
pii: S0002-8177(20)30365-2
doi: 10.1016/j.adaj.2020.04.026
pmc: PMC7387749
mid: NIHMS1603386
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
596-606Subventions
Organisme : NIDCR NIH HHS
ID : R03 DE027436
Pays : United States
Informations de copyright
Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved.
Références
NCHS Data Brief. 2015 May;(197):197
pubmed: 25973996
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Dec;94(6):687-91
pubmed: 12464891
J Rural Health. 2017 Sep;33(4):409-418
pubmed: 28905422
J Public Health Dent. 2014 Summer;74(3):219-26
pubmed: 24428804
J Am Dent Assoc. 2005 Feb;136(2):221-8
pubmed: 15782529
Inquiry. 2016 Jun 09;53:
pubmed: 27284127
Am J Public Health. 2014 Nov;104(11):2122-9
pubmed: 25211763
J Am Dent Assoc. 2002 Feb;133(2):167-75
pubmed: 11868835
J Public Health Dent. 2010 Jun;70 Suppl 1:S49-57
pubmed: 20806475
Vital Health Stat 11. 2007 Apr;(248):1-92
pubmed: 17633507
J Public Health Dent. 2014 Spring;74(2):102-9
pubmed: 24032402
Gen Dent. 2008 Jul-Aug;56(5):438-42
pubmed: 18683400
J Health Care Poor Underserved. 2013 May;24(2):892-906
pubmed: 23728055
Health Aff (Millwood). 2016 Dec 1;35(12):2200-2206
pubmed: 27920307
J Racial Ethn Health Disparities. 2016 Dec;3(4):565-572
pubmed: 27294750
J Periodontol. 2015 May;86(5):611-22
pubmed: 25688694
J Am Dent Assoc. 2001 May;132(5):655-64
pubmed: 11367970
J Public Health Dent. 2003 Summer;63(3):150-7
pubmed: 12962468
Spec Care Dentist. 2012 Mar;32(2):42-8
pubmed: 22416985
Community Dent Health. 2013 Sep;30(3):161-7
pubmed: 24151790
J Public Health Dent. 2011 Fall;71(4):308-17
pubmed: 22320289
J Am Dent Assoc. 2002 Dec;133(12):1672-81
pubmed: 12512669
Health Econ. 2014 Jan;23(1):14-32
pubmed: 23349123
Biometrics. 1999 Jun;55(2):652-9
pubmed: 11318229