Dr. Kranz is a policy researcher, at the RAND Corporation, Arlington, Va., USA;, Email:
Ms. Estrada-Darley is a PhD fellow and an assistant policy researcher, Pardee RAND Graduate School, Santa Monica, Calif., USA.
Pediatr Dent. 2021 Mar 15;43(2):109-117.
The purpose of this study was to examine receipt of preventive oral health services (POHS) by race/ethnicity for young Medicaid-enrollees following the enactment of state policies enabling medical providers to deliver POHS. Using Medicaid data (2006 to 2014) from 38 states for 8,711,192 child-years (aged six months to five years), logistic regressions were used to examine differences within and between racial/ethnic groups (white, black, Hispanic, and "other" race/ethnicity groups) in terms of adjusted probabilities of receiving POHS in medical offices or any medical or dental offices. Models were adjusted for years since policy enactment and estimated separately for states with and without requirements that medical providers obtain POHS training. Receipt of any POHS was 10.9 percentage points higher for Hispanic children and 4.7 percentage points higher for "other" race/ethnicity group children than white children after five or more years of policy enactment in states with training requirements (P<0.05). Findings for medical POHS and states without training requirements were similar but smaller in magnitude. Hispanic and "other" race/ethnicity group children benefitted more from the integration of POHS into medical offices than white children. Policies enabling delivery of POHS in medical offices increased receipt of POHS among some minority groups and may help to reduce disparities.
本研究旨在考察在州政策颁布后，接受医疗服务提供者提供的预防性口腔健康服务（POHS）的情况，这些政策使医疗服务提供者能够提供 POHS。利用来自 38 个州的 Medicaid 数据（2006 年至 2014 年），涵盖了 8711192 个儿童年（六个月至五岁），采用逻辑回归分析了在医疗办公室或任何医疗或牙科办公室接受 POHS 的调整后概率在种族/族裔群体（白种人、黑种人、西班牙裔和“其他”种族/族裔群体）之间的差异。模型调整了政策实施以来的年份，并分别针对要求医疗提供者获得 POHS 培训的州和没有要求的州进行了估计。在有培训要求的州，政策实施五年或五年以上后，西班牙裔儿童接受任何 POHS 的比例比白人儿童高 10.9 个百分点，“其他”种族/族裔群体儿童比白人儿童高 4.7 个百分点（P<0.05）。对于医疗 POHS 和没有培训要求的州，发现结果相似，但幅度较小。西班牙裔和“其他”种族/族裔群体儿童从 POHS 纳入医疗办公室中获益更多，而白人儿童则获益较少。使 POHS 能够在医疗办公室中提供的政策增加了一些少数民族群体接受 POHS 的机会，并可能有助于减少差距。
