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.
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.
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。
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