McKernan Susan C, Reynolds Julie C, Momany Elizabeth T, Kuthy Raymond A, Kateeb Elham T, Adrianse Nancy B, Damiano Peter C
J Am Dent Assoc. 2015 Jan;146(1):34-41.e3. doi: 10.1016/j.adaj.2014.11.014. Epub 2014 Dec 18.
The authors investigated the role of private practitioners in the dental safety net, including the provision of care for Medicaid enrollees and attitudinal factors that affect participation.
In 2013, the authors sent a mixed-mode survey to all general dentists in Iowa assessing their current Medicaid participation and factors affecting participation, including attitudinal statements about altruism, the Medicaid program, and the government's role in providing access to dental care.
Fifty-six percent of responding dentists accepted new Medicaid-enrolled patients; dentists living in nonmetropolitan areas were significantly more likely to accept Medicaid than were those in metropolitan areas. Results from a logistic regression model demonstrated that participating dentists scored significantly higher in altruistic attitudes and perceived problems with Medicaid as less important.
Dentists who accepted Medicaid-enrolled patients had significantly more positive attitudes about Medicaid administration and altruistic attitudes in general. Investigators in future studies should examine how these attitudes are shaped by educational and professional experiences.
Dentists' perceptions about Medicaid potentially are modifiable by changing program policies in ways to improve access for vulnerable populations, including new Medicaid enrollees.
作者调查了私人执业牙医在牙科安全网中的作用，包括为医疗补助计划参保者提供护理以及影响参与度的态度因素。
2013年，作者向爱荷华州的所有普通牙医发送了一份混合模式调查问卷，评估他们目前参与医疗补助计划的情况以及影响参与度的因素，包括关于利他主义、医疗补助计划以及政府在提供牙科护理可及性方面作用的态度陈述。
56%的回应牙医接受新加入医疗补助计划的患者；居住在非都市地区的牙医比都市地区的牙医更有可能接受医疗补助计划患者。逻辑回归模型结果表明，参与的牙医在利他态度方面得分显著更高，且认为医疗补助计划的问题不那么重要。
接受医疗补助计划参保患者的牙医总体上对医疗补助计划管理和利他态度有明显更积极的态度。未来研究的调查人员应研究这些态度是如何受教育和专业经历影响形成的。
通过改变项目政策以改善弱势群体（包括新加入医疗补助计划的参保者）的可及性，牙医对医疗补助计划的看法可能会得到改变。
