Dumas S Amanda, Polk Deborah
Division of Ambulatory Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
J Public Health Dent. 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086. Epub 2015 Feb 9.
Examine dental utilization by Medicaid-insured children living in a high-resource area. Characterize distance and travel-related variables to accessing care.
Cross-sectional data were collected on dental clinics in Pittsburgh, Pennsylvania, caring for Medicaid-insured children ≥1 year. Shortest distances, drive times, and bus travel between dental clinics and high-poverty census tracts were determined through geographical information systems analysis. Primary care clinic (PCC) survey data were analyzed for children's dental use. Demographic characteristics and travel-related variables were compared between children who had and had not been to a dentist.
Ten dental clinics accepted Medicaid-insured children ≥1 year. Mean distance between high-poverty census tracts and their nearest clinic was 1.2 miles [standard deviation (SD) 0.2 miles], with mean bus travel time 15.6 minutes (SD 12.3 minutes). Overall, 46 percent of PCC children reported a dental visit, and this was not significantly different between those who lived in a high-poverty census tract versus those who did not (41 percent and 35 percent, respectively, P = 0.58). Children traveled a mean distance of 4.75 miles (SD 2.37 miles) to their dental clinic. Mean distance to their nearest dental clinic was 2.81 miles (SD 2.12 miles).
Dental clinics in a high-resource area are in close proximity to where young Medicaid-insured children live; and distances between children's homes and dental clinics are not significantly different between children who had and had not reported a dental visit, suggesting that barriers persist despite close proximity. Regardless, closer proximity may contribute to the higher utilization of services observed compared with national rates.
调查生活在资源丰富地区的医疗补助保险儿童的牙科就诊情况。描述获得牙科护理的距离及与出行相关的变量。
收集宾夕法尼亚州匹兹堡市为1岁及以上医疗补助保险儿童提供服务的牙科诊所的横断面数据。通过地理信息系统分析确定牙科诊所与高贫困普查区之间的最短距离、驾车时间和公交出行时间。对初级保健诊所(PCC)的调查数据进行分析,以了解儿童的牙科就诊情况。比较去过和未去过牙医诊所的儿童的人口统计学特征及与出行相关的变量。
10家牙科诊所接收1岁及以上的医疗补助保险儿童。高贫困普查区与其最近诊所之间的平均距离为1.2英里[标准差(SD)0.2英里],平均公交出行时间为15.6分钟(SD 12.3分钟)。总体而言,46%的PCC儿童报告曾看过牙医,生活在高贫困普查区的儿童与未生活在高贫困普查区的儿童之间这一比例无显著差异(分别为41%和35%,P = 0.58)。儿童前往牙科诊所的平均距离为4.75英里(SD 2.37英里)。到其最近牙科诊所的平均距离为2.81英里(SD 2.12英里)。
资源丰富地区的牙科诊所距离接受医疗补助的年幼儿童居住地点较近;报告看过牙医和未看过牙医的儿童,其家庭与牙科诊所之间的距离无显著差异,这表明尽管距离较近,但障碍仍然存在。尽管如此,与全国 rates相比,距离较近可能有助于提高观察到的服务利用率。