The role of dentist supply, need for care and long-term continuity in Health Resources and Services Administration-funded health centres in the United States.
HRSA-funded health centres
delivery of care
dental utilization
oral health
Journal
Community dentistry and oral epidemiology
ISSN: 1600-0528
Titre abrégé: Community Dent Oral Epidemiol
Pays: Denmark
ID NLM: 0410263
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
07
10
2020
received:
06
04
2020
accepted:
02
11
2020
pubmed:
25
11
2020
medline:
21
5
2021
entrez:
24
11
2020
Statut:
ppublish
Résumé
Health Resources and Services Administration-funded health centres (HCs) are an important source of dental services for low-income and vulnerable patients in the United States. About 82% of HCs in 2018 had dental workforce, but it is unclear whether this workforce meets the oral health needs of HC patients. Thus, we first examined (a) whether dental workforce was associated with any dental visits vs none and (b) whether HC patients with any visits were more likely to have a visit at the HC vs elsewhere. We then examined (c) if need for oral health care and long-term continuity at the HC were associated with dental visits and visits at the HC. This study used the 2014 Health Center Patient Survey, a nationally representative study of US HC patients, and the 2013 Uniform Data System, an administrative dataset of HC characteristics. We also used the 2013 Area Health Resource File to measure the contribution of local supply of dentists. We included working-age adult patients (n = 5006) and used multilevel structural equation models with Poisson specification. Larger dental workforce at the HC was significantly associated with 1% higher likelihood (relative risk [RR]: 1.01, 1.00-1.02) of any visits and 10% higher likelihood of a visit at the HC among those with a visit (RR: 1.10, 1.06-1.14). Patient self-reported oral health need was positively associated with 157% higher likelihood of dental visits (RR: 2.57, 2.29-2.88), and 42% higher likelihood of dental visit at the HC vs elsewhere (RR: 1.42, 1.19-1.69). Long-term continuity with the HC was not significantly associated with likelihood of dental visits, but was associated with 26% higher likelihood of visits at the HC among those who had any visits (RR: 1.26, 1.02-1.56). The findings highlight the potential impact of increasing dental workforce at HCs to promote access; the high level of need for oral health care at HCs; and the increased effort required to promote access among newer patients who may be less familiar with the availability of oral health care at HCs. Together, these findings reinforce the importance of addressing barriers of use of oral health services among low-income and uninsured patients.
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
291-300Subventions
Organisme : HRSA HHS
ID : HHSH250201300023I
Pays : United States
Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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