Al Agili Dania E, Bronstein Janet M, Greene-McIntyre Mary
Department of Maternal and Child Health, School of Public Health, Birmingham, AL, USA.
Pediatr Dent. 2005 Sep-Oct;27(5):414-21.
The purposes of this survey were to assess barriers to utilization of dental services among Medicaid-enrolled Alabama children and identify families who used or did not use Medicaid-covered dental services.
A random sample of 4,500 parents of Medicaid-eligible children ages 3 to 19 years was surveyed. Participants came from Medicaid enrollment data stratified by area of residence into 3 groups: (1) large urban; (2) town; and (3) rural. Univariate and multivariate analyses were conducted.
The overall response rate was 40% (N = 1,766). Most respondents (71%) reported that their child had a dental visit in the past year. Compared to parents who had a dental visit, those who reported no visits were more likely to: (1) be non-Hispanic African American; (2) be less educated; (3) live in rural settings of Alabama; (4) have more children younger than 6 or older than 12; (5) have more children with disabling conditions; and (6) report poor perceived oral health. Respondents with no dental visits were grouped into 3 categories-those who: (1) believed they did not need dental care (46%); (2) thought dental care was hard to find (34%); and (3) tried but could not get dental care (20%). The first group had significantly less respondents with a high school or greater education, more reporting perceived good to excellent oral health, and more living in rural areas, compared to the other 2 groups.
Families who did not use Medicaid-covered dental services include: (1) a group with high perceived need and barriers to care; and (2) a group with little perceived need. Interventions must target both groups.
本调查旨在评估阿拉巴马州参加医疗补助计划的儿童在利用牙科服务方面的障碍，并识别使用或未使用医疗补助覆盖的牙科服务的家庭。
对4500名符合医疗补助条件的3至19岁儿童的家长进行了随机抽样调查。参与者来自按居住地区分层的医疗补助登记数据，分为3组：（1）大城市；（2）城镇；（3）农村。进行了单变量和多变量分析。
总体回复率为40%（N = 1766）。大多数受访者（71%）报告称他们的孩子在过去一年里看过牙医。与带孩子看过牙医的家长相比，那些报告孩子没看过牙医的家长更有可能：（1）是非西班牙裔非裔美国人；（2）受教育程度较低；（3）居住在阿拉巴马州的农村地区；（4）有更多6岁以下或12岁以上的孩子；（5）有更多残疾儿童；（6）报告口腔健康状况较差。未带孩子看过牙医的受访者分为3类：（1）认为自己不需要牙科护理的（46%）；（2）认为很难找到牙科护理的（34%）；（3）尝试过但无法获得牙科护理的（20%）。与其他两组相比，第一组中高中及以上学历的受访者明显较少，更多人报告口腔健康状况良好至极佳，且更多人居住在农村地区。
未使用医疗补助覆盖的牙科服务的家庭包括：（1）一组有较高护理需求但存在护理障碍的家庭；（2）一组几乎没有护理需求的家庭。干预措施必须针对这两组家庭。
