Dental access and expenditures for adults with intellectual and other disabilities.
Medicaid
dental care
health care surveys
health care utilization
health expenditures
health services accessibility
intellectual disability
Journal
Journal of public health dentistry
ISSN: 1752-7325
Titre abrégé: J Public Health Dent
Pays: United States
ID NLM: 0014207
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
30
07
2021
received:
31
12
2020
accepted:
12
10
2021
pubmed:
26
10
2021
medline:
29
1
2022
entrez:
25
10
2021
Statut:
ppublish
Résumé
Individuals with disabilities experience greater barriers accessing health care services and have poorer oral health outcomes than those without disabilities. The aims of this study were to examine dental access, utilization, expenditures, and sources of payment between adults with intellectual disabilities (ID), other types of disabilities, and without disabilities. Secondary analyses of data from the 2017 Medical Expenditure Panel Survey (MEPS) allowed examination of dental access (being able to get dental care and receiving necessary dental care without delay), dental utilization (having a dental visit in the past year), total dental expenditures, and associated sources of payment between three groups of adults based on disability status using descriptive, bivariate, and multivariable statistics. Adults with ID have 2.70 (95% CI: 2.03, 3.61) times the odds of being unable to get dental care and 2.88 (95% CI: 2.11, 3.94) times the odds of having to delay necessary dental care compared with adults without disabilities. No significant differences were observed in dental utilization or mean total dental expenditure between the three groups after adjusting for demographic and socioeconomic variables. Among adults who incurred a dental expenditure, adults with ID had a greater share of dental care paid for by Medicaid, and adults without disabilities had a greater share of dental care paid for by private insurance. Despite similar mean total dental expenditures, reduced dental access reported by adults with ID suggests that this population experiences significantly greater challenges obtaining dental care. Adults with ID rely more heavily on Medicaid to finance dental care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
299-307Informations de copyright
© 2021 American Association of Public Health Dentistry.
Références
Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of disabilities and health care access by disability status and type among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(32):882-7.
Oral health in America: a report of the surgeon general. Rockville, MD: Office of the Surgeon General (US); 2000.
The surgeon General's call to action to improve the health and wellness of persons with disabilities. Rockville, MD: Office of the Surgeon General (US); 2005.
Waldman HB, Perlman SP, Wong A. The largest minority population in the U.S. without adequate dental care. Spec Care Dentist. 2017;37(4):159-63.
Anderson LL, Larson SA, MapelLentz S, Hall-Lande J. A systematic review of U.S. studies on the prevalence of intellectual or developmental disabilities since 2000. Intellect Dev Disabil. 2019;57(5):421-38.
Facts About Intellectual Disability. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 2020.
Petrovic BB, Peric TO, Markovic DLJ, Bajkin BB, Petrovic D, Blagojevic DB, et al. Unmet oral health needs among persons with intellectual disability. Res Dev Disabil. 2016;59:370-7.
Morgan JP, Minihan PM, Stark PC, Finkelman MD, Yantsides KE, Park A, et al. The oral health status of 4,732 adults with intellectual and developmental disabilities. J Am Dent Assoc. 2012;143(8):838-46.
Chadwick D, Chapman M, Davies G. Factors affecting access to daily oral and dental care among adults with intellectual disabilities. J Appl Res Intellect Disabil. 2018;31(3):379-94.
Kelly G. How do intellectual disabilities affect oral health? Evid Based Dent. 2020;21(1):26-7.
Hall J, Kurth N. A comparison of health disparities among Americans with intellectual disability and/or autism spectrum disorder and Americans with other disabilities. Inc. 2019;7(3):160-8.
Mitra S, Findley PA, Sambamoorthi U. Health care expenditures of living with a disability: Total expenditures, out-of-pocket exepenses, and burden, 1996 to 2004. Arch Phys Med Rehabil. 2009;90(9):1532-40.
Horner-Johnson W, Dobbertin K. Dental insurance and dental care among working-age adults: differences by type and complexity of disability. J Public Health Dent. 2016;76(4):330-9.
Havercamp SM, Krahn GL, Larson SA, Fujiura G, Goode TD, Kornblau BL. Identifying people with intellectual and developmental disabilities in national population surveys. Intellect Dev Disabil. 2019;57(5):376-89.
Kranz AM, Ross R, Sorbero M, Kofner A, Stein BD, Dick AW. Impact of a Medicaid policy on preventive oral health services for children with intellectual disabilities, developmental disabilities, or both. J Am Dent Assoc. 2020;151(4):255-264.e253.
Dobbertin K, Horner-Johnson W, Lee JC, Andresen EM. Subgroup differences in having a usual source of health care among working-age adults with and without disabilities. Disabil Health J. 2015;8(2):296-302.
Horner-Johnson W, Dobbertin K, Lee JC, Andresen EM. Disparities in health care access and receipt of preventive services by disability type: analysis of the medical expenditure panel survey. Health Serv Res. 2014;49(6):1980-99.
Cohen J. Design and Methods of the medical expenditure panel survey household component. Rockville, MD: Agency for Health Care Policy and Research; 1997.
Machlin S, Yu W, Zodet M. Computing standard errors for MEPS estimates. Rockville, MD: Agency for Healthcare Research and Quality; 2005. https://meps.ahrq.gov/survey_comp/standard_errors.jsp
Compendium of Health Data Sources for Adults with Intellectual Disabilities. Center for Developmental Disabilities Evaluation and Research, Shriver Center, University of Massachusetts Medical School; 2011.
Reichard A, Stolzle H. Diabetes among adults with cognitive limitations compared to individuals with no cognitive disabilities. Intellect Dev Disabil. 2011;49(3):141-54.
Manski R, Rohde F. Dental services: use, expenses, source of payment, coverage and procedure type, 1996-2015. Research Findings No. 38. 2017.
Machlin SR, Muhuri P. Characteristics and health care expenditures of VA health system users versus other veterans, 2014-2015 (combined). MEPS Statistical Brief #508. 2018.
Wall T, Vujicic M. U.S. Dental Expenditures: 2017 Update. Health Policy Institute, American Dental Association 2017.
MEPS. HC-201 2017 full year consolidated data file documentation. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health & Human Services; 2019.
Nasseh K, Vujicic M. Dental care utilization steady among working-age adults and children, up slightly among the elderly. Chicago, IL: Health Policy Institute, American Dental Association; 2016.
Hayes SL, Salzber CA, McCarthy D, Radley DC, Abrams MK, Shah T, et al. High-need, high-cost patients: who are they and how do they use health care? The commonwealth fund. Issue Brief (Commonw Fund). 2016;26:1-14.
Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to othere types of health care services. Health Aff (Millwood). 2016;35(12):2176-82.
Medicaid Adult Dental Benefits: An Overview. Center for Health Care Strategies 2019.
Dentist Participation in Medicaid or CHIP. Health Policy Institute, American Dental Association. 2020.
National Core Indicators 2018-19 in-Person Survey (IPS) Report: Health. National Associaiton of State Directors of Developmenal Disabilities Services, Human Services Research Institute. https://www.nationalcoreindicators.org/upload/core-indicators/Health_508_IPS_18_19.pdf.
Manski RJ, Moeller JF, Chen H, Schimmel J, Pepper JV, St Clair PA. Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage. Health Serv Res. 2015;50(1):117-35.
Kaye HS. Disability-related disparities in access to health care before (2008-2010) and after (2015-2017) the affordable care act. Am J Public Health. 2019;109(7):1015-21.
Glassman P, Harrington M, Mertz E, Namakian M. The virtual dental home: implications for policy and strategy. J Calif Dent Assoc. 2012 Jul;40(7):605-11.