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Should Medicaid include adult coverage for preventive dental procedures? What evidence is needed?医疗补助是否应包括成年人预防性牙科治疗的覆盖范围?需要哪些证据?
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J Womens Health (Larchmt). 2020 Jan;29(1):29-37. doi: 10.1089/jwh.2019.7658. Epub 2019 Aug 9.

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Does preventive dental care reduce nonpreventive dental visits and expenditures among Medicaid-enrolled adults?预防性牙科保健是否能减少医疗补助计划覆盖的成年人的非预防性牙科就诊次数和支出?
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本文引用的文献

1
Changes in emergency department dental visits after Medicaid expansion.医疗补助扩大后急诊牙科就诊的变化。
Health Serv Res. 2020 Jun;55(3):367-374. doi: 10.1111/1475-6773.13261. Epub 2020 Jan 15.
2
What is health economics?什么是健康经济学?
Community Dent Health. 2019 Nov 28;36(4):262-274. doi: 10.1922/CDH_4581Listl13.
3
For careful consideration: the reporting of health economic evaluations in dentistry.
J Public Health Dent. 2019 Dec;79(4):273-274. doi: 10.1111/jphd.12344. Epub 2019 Oct 10.
4
The demand for preventive and restorative dental services among older adults.老年人对预防和修复性牙科服务的需求。
Health Econ. 2019 Sep;28(9):1151-1158. doi: 10.1002/hec.3921. Epub 2019 Jul 2.
5
A systematic review of the quality and scope of economic evaluations in child oral health research.儿童口腔健康研究中经济评估的质量和范围的系统评价。
BMC Oral Health. 2019 Jul 1;19(1):132. doi: 10.1186/s12903-019-0825-2.
6
Factors Associated with Emergency Department Use for Non-traumatic Dental Problems: Scoping Review.与非创伤性牙科问题的急诊科就诊相关的因素:范围综述
J Can Dent Assoc. 2019 Mar;84:j3.
7
What evidence do economic evaluations in dental care provide? A scoping review.牙科护理中的经济评估提供了哪些证据?一项范围综述。
Community Dent Health. 2019 May 30;36(2):118-125. doi: 10.1922/CDH_4426Eow08.
8
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.医疗补助计划对成年非紧急牙科福利与牙科服务使用和支出的关联。
J Am Dent Assoc. 2019 Jan;150(1):24-33. doi: 10.1016/j.adaj.2018.08.010. Epub 2018 Sep 25.
9
Does providing dental services reduce overall health care costs?: A systematic review of the literature.提供牙科服务是否能降低总体医疗保健成本?:文献系统评价。
J Am Dent Assoc. 2018 Aug;149(8):696-703.e2. doi: 10.1016/j.adaj.2018.03.023. Epub 2018 Jun 14.
10
First do no harm - The impact of financial incentives on dental X-rays.首要原则是不伤害 - 财务激励对牙科 X 光的影响。
J Health Econ. 2018 Mar;58:1-9. doi: 10.1016/j.jhealeco.2017.12.005. Epub 2017 Dec 30.

医疗补助是否应包括成年人预防性牙科治疗的覆盖范围?需要哪些证据?

Should Medicaid include adult coverage for preventive dental procedures? What evidence is needed?

出版信息

J Am Dent Assoc. 2020 Aug;151(8):607-613. doi: 10.1016/j.adaj.2020.05.005.

DOI:10.1016/j.adaj.2020.05.005
PMID:32718490
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7392117/
Abstract

BACKGROUND

Medicaid programs may have a salient financial incentive to provide adult coverage for cost-effective preventive dental procedures because they face responsibility for catastrophic costs of dental disease. Whether there is sufficient evidence to support adult Medicaid coverage of preventive dental services is unclear.

METHODS

Using an optimal insurance model, the author examines what evidence there is to support coverage of cost-effective preventive dental services in Medicaid and what evidence gaps remain.

RESULTS

There is insufficient evidence to support adult Medicaid coverage for preventive dental procedures.

CONCLUSIONS

More research is needed to identify preventive dental procedures that are cost-effective from a Medicaid perspective, quantify the impact dental prevention has on dental-related health care costs and overall health care costs, and quantify the impact patient-side and provider-side financial incentives have on take-up of specific preventive dental treatments.

PRACTICAL IMPLICATIONS

Although Medicaid programs may have an interest in preventing catastrophic costs of dental disease (that is, dental-related emergency department visits), there is insufficient evidence for Medicaid programs to provide coverage for preventive dental procedures.

摘要

背景

医疗补助计划可能有明显的经济激励来为具有成本效益的预防性牙科治疗提供成人保险,因为他们要承担因牙科疾病而产生的灾难性医疗费用的责任。目前尚不清楚是否有足够的证据支持为成人医疗补助计划提供预防性牙科服务。

方法

作者使用最优保险模型,研究了为医疗补助计划中的具有成本效益的预防性牙科服务提供保险的依据是什么,以及仍存在哪些证据缺口。

结果

没有足够的证据支持为成人医疗补助计划提供预防性牙科治疗。

结论

需要更多的研究来确定从医疗补助角度来看哪些预防性牙科治疗具有成本效益,量化牙科预防对牙科相关医疗保健成本和整体医疗保健成本的影响,以及量化患者和提供者双方的经济激励对特定预防性牙科治疗的采用的影响。

实际意义

尽管医疗补助计划可能有兴趣预防因牙科疾病而产生的灾难性医疗费用(即与牙科相关的急诊就诊),但目前尚无足够的证据支持为成人医疗补助计划提供预防性牙科治疗。