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牙科诊所接纳医疗补助患者方面的种族/族裔差异。

Racial/ethnic disparities in the acceptance of Medicaid patients in dental practices.

作者信息

Okunseri Christopher, Bajorunaite Ruta, Abena Albert, Self Karl, Iacopino Anthony M, Flores Glenn

机构信息

Department of Clinical Services Room 356, Marquette University School of Dentistry, P.O. Box 1881 Milwaukee, WI 53201-1881, USA.

出版信息

J Public Health Dent. 2008 Summer;68(3):149-53. doi: 10.1111/j.1752-7325.2007.00079.x.

Abstract

OBJECTIVES

Medicaid enrollees disproportionately experience dental disease and difficulties accessing needed dental care. However, little has been documented on the factors associated with the acceptance of new Medicaid patients by dentists, and particularly whether minority dentists are more likely to accept new Medicaid patients. We therefore examined the factors associated with the acceptance of new Medicaid patients by dentists.

METHODS

We analyzed 2001 data from the Wisconsin Dentist Workforce Survey administered by the Wisconsin Division of Health Care Financing, Bureau of Health Information. We used descriptive statistics and logistic regression analysis to examine the factors associated with the outcome variable.

RESULTS

Ninety-four percent of Wisconsin licensed dentists (n = 4,301) responded to the 2001 survey. A significantly higher likelihood of accepting new Medicaid patients was found for racial/ethnic minority dentists (35 versus 19 percent of White dentists) and dentists practicing in large practices (31 versus 16 percent for those in smaller practices). In the multivariable analysis, minority dentists [odds ratio (OR) = 2.06, 95 percent confidence interval (CI) = 1.30, 3.25] and dentists in practices with >3 dentists (OR= 2.25, 95 percent CI = 1.69, 3.00) had significantly greater odds of accepting new Medicaid patients.

CONCLUSIONS

Racial/ethnic minority dentists are twice as likely as White dentists to accept new Medicaid patients. Dentists in larger practices also are significantly more likely than those in smaller practices to accept new Medicaid patients. These findings suggest that increasing dental workforce diversity to match the diversity of the general US population can potentially improve access to dental care for poor and minority Americans, and may serve as an important force in reducing disparities in dental care.

摘要

目的

医疗补助计划参保者患牙病的比例过高,且在获得所需牙科护理方面存在困难。然而,关于牙医接受新的医疗补助计划患者的相关因素,鲜有文献记载,尤其是少数族裔牙医是否更有可能接受新的医疗补助计划患者。因此,我们研究了与牙医接受新的医疗补助计划患者相关的因素。

方法

我们分析了由威斯康星州医疗保健融资部健康信息局管理的2001年威斯康星州牙医劳动力调查数据。我们使用描述性统计和逻辑回归分析来研究与结果变量相关的因素。

结果

94%的威斯康星州持证牙医(n = 4301)对2001年的调查做出了回应。研究发现,种族/族裔少数族裔牙医接受新的医疗补助计划患者的可能性显著更高(白人牙医为19%,而少数族裔牙医为35%),以及在大型诊所执业的牙医(小型诊所的牙医为16%,而大型诊所的牙医为31%)。在多变量分析中,少数族裔牙医[优势比(OR)= 2.06,95%置信区间(CI)= 1.30,3.25]和诊所牙医人数超过3人的牙医(OR = 2.25,95%CI = 1.69,3.00)接受新的医疗补助计划患者的几率显著更高。

结论

种族/族裔少数族裔牙医接受新的医疗补助计划患者的可能性是白人牙医的两倍。大型诊所的牙医接受新的医疗补助计划患者的可能性也显著高于小型诊所的牙医。这些发现表明,增加牙科劳动力的多样性以匹配美国普通人群的多样性,可能会改善贫困和少数族裔美国人获得牙科护理的机会,并可能成为减少牙科护理差距的重要力量。

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