Industrial and Systems Engineering School, Georgia Institute of Technology, Atlanta, Georgia.
Industrial Engineering, University of Louisville, Louisville, Kentucky.
Prev Chronic Dis. 2017 Oct 26;14:E104. doi: 10.5888/pcd14.170176.
We compared access to preventive dental care among low-income children eligible for public dental insurance to access among children with private dental insurance and/or high family income (>400% of the federal poverty level) in Georgia, and the effect of policies toward increasing access to dental care for low-income children.
We used multiple sources of data (eg, US Census, Georgia Board of Dentistry) to estimate, by census tract, measures of preventive dental care access in 2015 for children aged 0 to 18 years. Measures were percentage of met need, 1-way travel distance to a dentist, and scarcity of dentists. We used an optimization model to estimate access, quantify disparities, and evaluate policies.
About 1.5 million children were eligible for public insurance; 600,000 had private insurance and/or high family income. Across census tracts, average met need was 59% for low-income children and 96% for high-income children; for rural census tracts, these values were 33% and 84%, respectively. The average 1-way travel distance for all census tracts was 3.7 miles for high-income and/or privately insured children and 17.2 miles for low-income children; for rural census tracts, these values were 11.6 and 32.9 miles, respectively. Increasing dentists' acceptance of public insurance-eligible children increased met need more in rural areas than in urban areas. To achieve 100% met need in rural tracts, however, an 80% participation rate among dentists would be required.
Across census tracts, high-income children had better access to preventive dental care than low-income children had. Identifying tracts with disparities in access could result in more efficient allocation of public health dental resources.
我们比较了佐治亚州符合公共牙科保险条件的低收入儿童与有私人牙科保险和/或高家庭收入（超过联邦贫困线的 400%）的儿童获得预防性牙科保健的机会，并评估了增加低收入儿童获得牙科保健机会的政策的效果。
我们使用多种数据源（例如，美国人口普查，佐治亚州牙科委员会），根据普查区估算 2015 年 0 至 18 岁儿童的预防性牙科保健机会的衡量标准。衡量标准为满足需求的百分比、到牙医的单程旅行距离和牙医的稀缺程度。我们使用优化模型来估计机会，量化差异，并评估政策。
约有 150 万儿童有资格参加公共保险；60 万儿童有私人保险和/或高家庭收入。在各个普查区，低收入儿童的平均满足需求为 59%，高收入儿童为 96%；对于农村普查区，这些值分别为 33%和 84%。所有普查区的平均单程旅行距离对于高收入和/或私人保险的儿童为 3.7 英里，对于低收入儿童为 17.2 英里；对于农村普查区，这些值分别为 11.6 和 32.9 英里。增加牙医对符合公共保险资格的儿童的接受度，可使农村地区的满足需求程度比城市地区更高。但是，要使农村地区的满足需求达到 100%，牙医的参与率需要达到 80%。
在各个普查区，高收入儿童比低收入儿童更容易获得预防性牙科保健。确定在获得机会方面存在差异的普查区，可以更有效地分配公共卫生牙科资源。
