Department of Clinical Services, School of Dentistry, Marquette University, Milwaukee, WI, USA.
Institute of Health and Equity, Division of Biostatistics,Medical College of Wisconsin, Milwaukee, WI, USA.
J Public Health Dent. 2021 Sep;81(3):198-205. doi: 10.1111/jphd.12432. Epub 2020 Dec 1.
To determine the patterns and time trends of dental services received and access to dental care among immigrant and US-born children living in the United States.
We analyzed the nationally representative Medical Expenditure Survey data for 2007-2015. Survey weighted mean and frequency were calculated for all the years and for each year for the complete cohort and for the four subgroups of children categorized based on the child's and parents' birthplace (United States or Foreign). These groups were compared to detect differences in dental service received.
Overall 34,482 children aged <18 years were included in the analysis representing the weighted sample size of 564,255,643. Utilization of preventive dental services increased from 37.2 percent in 2007 to 44.4 percent in 2015 overall (P < 0.0001), with similar trend seen within all subgroups. Immigrant children compared to US-born children had higher numbers of surgical and restorative procedures (17 versus 16 per 100-person years, P = 0.03), fewer had at least one preventive dental visit in a year (32.8 percent versus 43.0 percent, P < 0.0001) and were less likely be unable to access dental care (3.0 percent versus 1.7 percent, P = 0.005). Fewer children had delayed access to dental care in recent years (2.0 percent in 2007 to 1.5 percent in 2015) and the decline was consistent in all the subgroups.
Stratification into the different subgroups allowed for improved understanding of dental procedure utilization and dental services utilization in all subgroups increased over time. Immigrant children had lower utilization of preventive procedures and higher utilization of surgical and restorative procedures.
确定居住在美国的移民和美国出生的儿童接受牙科服务和获得牙科保健的模式和时间趋势。
我们分析了 2007-2015 年全国代表性的医疗支出调查数据。计算了所有年份和每个年份的完整队列以及根据儿童和父母出生地(美国或外国)分类的四个儿童亚组的调查加权平均值和频率。这些组被比较以检测所接受的牙科服务的差异。
共有 34482 名年龄<18 岁的儿童纳入分析,代表了 564255643 人的加权样本量。总体而言,预防性牙科服务的利用率从 2007 年的 37.2%增加到 2015 年的 44.4%(P<0.0001),所有亚组均呈现出类似的趋势。与美国出生的儿童相比,移民儿童接受的手术和修复程序更多(每 100 人年 17 次与 16 次,P=0.03),每年至少有一次预防性牙科就诊的人数较少(32.8%与 43.0%,P<0.0001),无法获得牙科保健的可能性也较小(3.0%与 1.7%,P=0.005)。近年来,儿童延迟获得牙科保健的情况较少(2007 年为 2.0%,2015 年为 1.5%),所有亚组的下降趋势一致。
分层到不同的亚组可以更好地理解牙科手术利用情况,所有亚组的牙科服务利用率随着时间的推移而增加。移民儿童预防性手术利用率较低,手术和修复手术利用率较高。