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医疗补助福利扩展有实际效果吗?医疗补助成人牙科保险对牙科服务使用和口腔健康的影响。

Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.

作者信息

Decker Sandra L, Lipton Brandy J

机构信息

National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, United States.

National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, United States.

出版信息

J Health Econ. 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009. Epub 2015 Oct 22.

DOI:10.1016/j.jhealeco.2015.08.009
PMID:26519908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6758545/
Abstract

This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Our findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries. We are among the first to detect an effect of Medicaid coverage on a clinical health outcome other than mortality. These findings may have implications for states expanding Medicaid coverage to adults with incomes of up to 138% of the federal poverty threshold under the Affordable Care Act as most of these states offer an adult dental benefit.

摘要

本文利用2000 - 2012年各州牙科保险范围的差异,研究了医疗补助计划对成年人牙科保险的覆盖情况对牙科护理使用及牙齿健康结果的影响。我们的研究结果表明,牙科保险覆盖与近期看牙可能性的增加相关,这种影响的程度随着向牙医支付的医疗补助费率的提高而增大,同时未治疗龋齿的可能性降低。我们是首批发现医疗补助覆盖对除死亡率之外的临床健康结果有影响的研究团队之一。这些研究结果可能对那些根据《平价医疗法案》将医疗补助覆盖范围扩大到收入高达联邦贫困线138%的成年人的州具有启示意义,因为这些州中的大多数都提供成人牙科福利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/a5c730957622/nihms-1051043-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/de181c0b19f9/nihms-1051043-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/be55d576526b/nihms-1051043-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/a5c730957622/nihms-1051043-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/de181c0b19f9/nihms-1051043-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/be55d576526b/nihms-1051043-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c7/6758545/a5c730957622/nihms-1051043-f0003.jpg

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本文引用的文献

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Shaking up the dental safety-net: elimination of optional adult dental Medicaid benefits in California.撼动牙科安全网:加利福尼亚州取消成人牙科医疗补助的可选福利
J Health Care Poor Underserved. 2014 Feb;25(1 Suppl):151-64. doi: 10.1353/hpu.2014.0072.
2
Health reform in Massachusetts increased adult dental care use, particularly among the poor.马萨诸塞州的医疗改革增加了成年人的牙科保健使用,特别是在贫困人口中。
Health Aff (Millwood). 2013 Sep;32(9):1639-45. doi: 10.1377/hlthaff.2012.1332.
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The Oregon experiment--effects of Medicaid on clinical outcomes.俄勒冈实验——医疗补助对临床结果的影响。
N Engl J Med. 2013 May 2;368(18):1713-22. doi: 10.1056/NEJMsa1212321.
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The impact of dental treatment on employment outcomes: a systematic review.牙科治疗对就业结果的影响:系统评价。
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Mortality and access to care among adults after state Medicaid expansions.州医疗补助扩大后成年人的死亡率和获得护理的情况。
N Engl J Med. 2012 Sep 13;367(11):1025-34. doi: 10.1056/NEJMsa1202099. Epub 2012 Jul 25.
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The impact of Medicaid insurance coverage on dental service use.医疗补助保险覆盖范围对牙科服务利用的影响。
J Health Econ. 2011 Sep;30(5):1020-31. doi: 10.1016/j.jhealeco.2011.08.002. Epub 2011 Aug 12.
8
Medicaid payment levels to dentists and access to dental care among children and adolescents.医疗补助计划向牙医支付的费用水平与儿童和青少年获得牙科保健服务的情况。
JAMA. 2011 Jul 13;306(2):187-93. doi: 10.1001/jama.2011.956.
9
The individual and program impacts of eliminating Medicaid dental benefits in the Oregon Health Plan.取消俄勒冈健康计划中的医疗补助牙科福利对个人和项目的影响。
Am J Public Health. 2011 Nov;101(11):2144-50. doi: 10.2105/AJPH.2010.300031. Epub 2011 Jun 16.
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Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey.刷牙、炎症与心血管疾病风险:来自苏格兰健康调查的结果。
BMJ. 2010 May 27;340:c2451. doi: 10.1136/bmj.c2451.