北卡罗来纳州医疗补助计划参保儿童在全身麻醉下的牙科治疗及费用支出

Dental Treatment and Expenditures Under General Anesthesia Among Medicaid-Enrolled Children in North Carolina.

作者信息

Meyer Beau D, Lee Jessica Y, Casey Mark W

机构信息

Research assistant professor, Department of Pediatric Dentistry, School of Dentistry, at the University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA;, Email:

Distinguished professor and chair of Pediatric Dentistry at the School of Dentistry, and Professor in Health Policy and Management, Gillings School of Global Public Health, at the University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA.

出版信息

Pediatr Dent. 2017 Nov 1;39(7):439-444.

PMID:29335049

Abstract

PURPOSE

Many studies reporting dental utilization under general anesthesia (GA) are dated. The purpose of this study was to provide contemporaneous data about children receiving dental GA by: (1) determining trends in utilization and associated expenditures; and (2) examining the effects of provider distribution.

METHODS

This time series cross-sectional study of Medicaid-eligible children ages zero to eight years old in North Carolina used aggregate Medicaid claims from State Fiscal Years (SFY) 2011 to 2015 to collect demographic and dental treatment information. Descriptive statistics were stratified by age and year to examine trends over time. Panel analysis techniques were used to explore regional effects of provider distribution on dental GA utilization.

RESULTS

For SFY 2011 to 2015, the overall dental utilization rate was 517.1 per 1,000 (total enrolled equals 632,941 children/year), and the dental GA utilization rate was 15.8 per 1,000. Total dental expenditures averaged $113 million per year, and dental GA averaged $16.7 million per year. The dental GA proportion of expenditures increased over time (P<.001). Provider distribution did not affect dental GA utilization rate (P=.178) but did increase the number of children receiving dental GA (P<.001).

CONCLUSIONS

Utilization and expenditures associated with dental treatment under general anesthesia continue to increase. While this reflects increased access to care, interventions should be examined to provide preventive care earlier in a child's life.

摘要

目的

许多报告全身麻醉（GA）下牙科治疗利用率的研究都已过时。本研究的目的是通过以下方式提供有关接受牙科全身麻醉儿童的同期数据：（1）确定利用率和相关支出的趋势；（2）研究提供者分布的影响。

方法

这项针对北卡罗来纳州符合医疗补助条件的0至8岁儿童的时间序列横断面研究，使用了2011年至2015年州财政年度（SFY）的医疗补助汇总索赔数据，以收集人口统计学和牙科治疗信息。描述性统计按年龄和年份分层，以研究随时间的趋势。面板分析技术用于探讨提供者分布对牙科全身麻醉利用率的区域影响。

结果

在2011年至2015年州财政年度期间，总体牙科治疗利用率为每1000人中有517.1人次（每年登记的儿童总数为632,941人），牙科全身麻醉利用率为每1000人中有15.8人次。牙科治疗总支出平均每年1.13亿美元，牙科全身麻醉平均每年1670万美元。牙科全身麻醉支出的比例随时间增加（P<.001）。提供者分布不影响牙科全身麻醉利用率（P=.178），但确实增加了接受牙科全身麻醉的儿童数量（P<.001）。