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在密苏里州和威斯康星州,获得牙科护理的地理便利性存在差异。

Geographic access to dental care varies in Missouri and Wisconsin.

作者信息

Nasseh Kamyar, Eisenberg Yochai, Vujicic Marko

机构信息

American Dental Association, Health Policy Institute, Chicago, IL, USA.

出版信息

J Public Health Dent. 2017 Jun;77(3):197-206. doi: 10.1111/jphd.12197. Epub 2017 Jan 11.

DOI:10.1111/jphd.12197
PMID:28075494
Abstract

OBJECTIVE

To examine geographic access to dental providers for the general population and children with public insurance in Missouri and Wisconsin.

METHODS

Using a newly constructed dentist office database from the American Dental Association master file and other sources, we use the two-step floating area catchment area method to calculate population to provider ratios at the census block group level. These ratios are used to determine potential geographic dentist shortage areas. We utilize street network data to estimate travel times and catchment areas between population centers and dental offices. This methodology accounts for the actual spatial distribution of dental providers and potential dental patients.

RESULTS

Within and across Missouri and Wisconsin, there is some variation in geographic access to dental offices for the general population and publicly insured children. More than 90 percent of publicly insured children have access to dental providers within 30 minutes. Among the states examined, Missouri has more geographic disparities to dental care.

CONCLUSION

The Health Resources and Services Administration, which designates dental health professional shortage areas, relies on administrative boundaries to calculate population to dental provider ratios. These boundaries may not reflect actual or "real-time" dental care markets. The methods employed in this paper may give policymakers a template to better determine geographic dentist shortage areas.

摘要

目的

研究密苏里州和威斯康星州普通人群及参加公共保险儿童获得牙科服务提供者的地理可达性。

方法

利用从美国牙科协会主文件及其他来源新建的牙医诊所数据库,我们采用两步浮动区域集水区法在人口普查街区组层面计算人口与服务提供者的比例。这些比例用于确定潜在的地理牙医短缺地区。我们利用街道网络数据估计人口中心与牙科诊所之间的出行时间和集水区。该方法考虑了牙科服务提供者和潜在牙科患者的实际空间分布。

结果

在密苏里州和威斯康星州内部及两州之间,普通人群和参加公共保险儿童获得牙科诊所服务的地理可达性存在一些差异。超过90%参加公共保险的儿童能够在30分钟内获得牙科服务提供者的服务。在所研究的州中,密苏里州在牙科护理方面的地理差异更大。

结论

指定牙科健康专业人员短缺地区的卫生资源与服务管理局依靠行政边界来计算人口与牙科服务提供者的比例。这些边界可能无法反映实际或“实时”的牙科护理市场。本文采用的方法可为政策制定者提供一个模板,以更好地确定地理牙医短缺地区。

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