Grembowski D, Milgrom P M
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195-7660, USA.
Public Health Rep. 2000 Sep-Oct;115(5):448-59. doi: 10.1093/phr/115.5.448.
Washington State's Access to Baby and Child Dent stry (ABCD) Program, first implemented in Spokane County in 1995, offers extended dental benefits to participating Medicaid-enrolled children and higher fees for certified providers. This study aimed to determine the program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge.
The study used a posttest-only comparison group design. Trained interviewers conducted telephone interviews with 465 parents of chi dren ages 13 to 36 months (49% ABCD, 51% Medicaid-enrolled children not in ABCD). One year later, 282 of 465 parents completed a follow-up survey. Utilization and expenditures were calculated from Medicaid claims.
Forty-three percent of children in the ABCD Program visited a dentist in the follow-up year, compared with 12% of Medicaid-enrolled children not in the ABCD Program. An ABCD child was 5.3 times as likely to have had at least one dental visit as a child not in the program. ABCD children were 4 to 13 times as likely to have used specific dental services. Parents of ABCD children were more likely to report having ever tried to make a dental appointment, less likely to report that their children were fearful of the dentist, and were more satisfied, compared to parents of non-ABCD children.
The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction.
华盛顿州的儿童牙科服务准入项目(ABCD项目)于1995年在斯波坎县首次实施,为参与该项目的医疗补助参保儿童提供了扩展的牙科福利,并为认证提供者支付更高的费用。本研究旨在确定该项目对儿童牙科就诊率和牙科恐惧、以及家长满意度和知识的影响。
本研究采用仅后测的对照组设计。经过培训的访谈员对465名年龄在13至36个月儿童的家长进行了电话访谈(49%为ABCD项目组儿童,51%为参加医疗补助但未参加ABCD项目的儿童)。一年后,465名家长中有282名完成了随访调查。牙科就诊率和费用支出通过医疗补助报销数据计算得出。
在随访年度,ABCD项目组中有43%的儿童看过牙医,而参加医疗补助但未参加ABCD项目的儿童中这一比例为12%。参加ABCD项目的儿童至少进行过一次牙科就诊的可能性是未参加该项目儿童的5.3倍。参加ABCD项目的儿童使用特定牙科服务的可能性是未参加项目儿童的4至13倍。与未参加ABCD项目儿童的家长相比,参加ABCD项目儿童的家长更有可能报告曾尝试预约看牙,不太可能报告他们的孩子害怕看牙医,并且满意度更高。
作者得出结论,ABCD项目在增加医疗补助参保学龄前儿童的牙科就诊机会、减少牙科恐惧以及提高家长满意度方面是有效的。