Department of Community Health, National University, San Diego, CA, USA.
University of Miami, Public Health Sciences, Miami, FL, USA.
J Public Health Dent. 2022 Sep;82(4):365-371. doi: 10.1111/jphd.12460. Epub 2021 May 24.
Oral health is essential to a person's overall health, well-being, and dignity; unfortunately, dental caries, which can cause pain and difficulty eating, affect approximately 50 percent of children between 6 and 8 years old. This is in part because Medicaid-eligible children face numerous obstacles obtaining dental care. To date, there are 74 million Americans who do not have dental coverage or access to dental services, which is strongly associated with race, class, gender, and ethnicity. The objective of this research was to identify barriers to accessing and utilizing children's Medicaid oral health care and services, to evaluate care delivery and quality, and to assist in establishing a more consumer-driven approach.
A mixed methods study was conducted throughout the state of Florida, using qualitative and quantitative data collection to seek answers to these questions. There were 422 surveys and 39 interviews distributed to Medicaid-eligible families and individuals across the state; data collection focused on experiences with oral health care, gaps in current access to Medicaid dental care, and concerns when utilizing care.
Our study shows the majority of barriers parents face when accessing Medicaid oral health care are due to logistical access issues, such as cost, appointment wait-times, and confusion surrounding which dental providers accept specific insurance plans. The findings also highlight how location, race, language, and ethnicity impact families who lack preventive dental health services access and how, in turn, families view their own access to dental services.
Ultimately, there exists an avenue to implement programs and policies that address existing disparities in oral health to improve health outcomes by increasing access to care and reducing cultural and socioeconomic barriers.
口腔健康是一个人的整体健康、幸福和尊严的基础;不幸的是,龋齿会导致疼痛和进食困难,影响大约 50%的 6 至 8 岁儿童。这在一定程度上是因为符合医疗补助资格的儿童在获得牙科保健方面面临诸多障碍。迄今为止,有 7400 万美国人没有牙科保险或无法获得牙科服务,这与种族、阶级、性别和族裔密切相关。本研究的目的是确定获取和利用儿童医疗补助口腔保健和服务的障碍,评估护理的提供和质量,并协助建立更以消费者为导向的方法。
本研究在佛罗里达州全境开展了一项混合方法研究,使用定性和定量数据收集来回答这些问题。在全州范围内向符合医疗补助条件的家庭和个人分发了 422 份调查和 39 份访谈,数据收集重点是口腔保健体验、当前获得医疗补助牙科护理的差距以及使用护理时的担忧。
我们的研究表明,父母在获取医疗补助口腔保健时面临的大多数障碍是由于后勤获取问题,例如成本、预约等待时间以及对哪些牙科提供者接受特定保险计划的困惑。研究结果还强调了位置、种族、语言和族裔如何影响缺乏预防性牙科保健服务的家庭,以及家庭如何看待自己获得牙科服务的机会。
最终,可以实施一些项目和政策,以解决口腔健康方面现存的差异,通过增加获得护理的机会并减少文化和社会经济障碍,来改善健康结果。