Suppr超能文献

医疗补助计划的成人牙科福利与低收入老年群体的口腔健康。

Medicaid adult dental benefits and oral health of low-income older adults.

出版信息

J Am Dent Assoc. 2021 Jul;152(7):551-559.e1. doi: 10.1016/j.adaj.2021.03.010.

Abstract

BACKGROUND

Older adults are keeping their natural teeth longer, spurring calls for dental coverage under Medicare. Although Medicare dental coverage would benefit all older adults, the poorest among them are already eligible for dental benefits through Medicaid. The authors examine the association between states' Medicaid adult dental benefits and dental care use and tooth loss among low-income older adults.

METHODS

Using the Behavioral Risk Factor Surveillance System data from 2014, 2016, and 2018, the authors examined adults 65 years or older. The outcomes examined included annual dental visit and partial and complete tooth loss. Poisson regressions were used to obtain risk ratios after adjusting for covariates.

RESULTS

States' Medicaid adult dental benefits were significantly associated with dental care use, with low-income older adults in states with no coverage having the lowest probability of visiting a dentist (risk ratio [RR], 0.83; 95% CI, 0.74 to 0.94), followed by emergency-only coverage (RR, 0.91; 95% CI, 0.84 to 0.98) and limited benefits (RR, 0.91; 95% CI, 0.85 to 0.98) relative to states with extensive benefits. There were no significant differences in either partial or complete tooth loss.

CONCLUSIONS

States' Medicaid adult dental benefits are significantly associated with dental visits among low-income seniors. Providing comprehensive dental benefits under Medicaid can improve access to dental care among low-income older adults.

PRACTICAL IMPLICATIONS

As the older adult patient population grows, the poorest older adults may face barriers to dental care in the absence of dental coverage. Dental professionals must engage in advocating for comprehensive dental coverage, especially for vulnerable populations.

摘要

背景

老年人保留自然牙齿的时间更长,这促使人们呼吁将牙科纳入医疗保险范围。尽管医疗保险的牙科覆盖范围将使所有老年人受益,但其中最贫困的老年人已经通过医疗补助获得了牙科福利。作者研究了各州医疗补助成人牙科福利与低收入老年人的牙科护理使用和牙齿缺失之间的关系。

方法

作者使用 2014 年、2016 年和 2018 年的行为风险因素监测系统数据,研究了 65 岁及以上的成年人。检查的结果包括每年的牙科就诊和部分及全部牙齿缺失。在调整了协变量后,使用泊松回归获得风险比。

结果

各州的医疗补助成人牙科福利与牙科护理使用显著相关,没有覆盖范围的低收入老年人去看牙医的可能性最低(风险比 [RR],0.83;95%置信区间 [CI],0.74 至 0.94),其次是仅急诊覆盖(RR,0.91;95% CI,0.84 至 0.98)和有限福利(RR,0.91;95% CI,0.85 至 0.98),与广泛福利的州相比。在部分或全部牙齿缺失方面没有显著差异。

结论

各州的医疗补助成人牙科福利与低收入老年人的牙科就诊显著相关。在医疗补助计划下提供全面的牙科福利可以改善低收入老年人获得牙科护理的机会。

实用意义

随着老年患者群体的增长,最贫困的老年人在没有牙科覆盖的情况下可能面临牙科护理的障碍。牙科专业人员必须参与倡导全面的牙科覆盖,特别是针对弱势群体。

相似文献

1
Medicaid adult dental benefits and oral health of low-income older adults.
J Am Dent Assoc. 2021 Jul;152(7):551-559.e1. doi: 10.1016/j.adaj.2021.03.010.
2
Impact of Medicaid dental coverage expansion on self-reported tooth loss in low-income adults.
J Am Dent Assoc. 2022 Sep;153(9):839-847. doi: 10.1016/j.adaj.2022.03.003. Epub 2022 May 3.
3
Dental Outcomes After Medicaid Insurance Coverage Expansion Under the Affordable Care Act.
JAMA Netw Open. 2021 Sep 1;4(9):e2124144. doi: 10.1001/jamanetworkopen.2021.24144.
5
Effects of the Recent Medicaid Expansions on Dental Preventive Services and Treatments.
Med Care. 2020 Aug;58(8):749-755. doi: 10.1097/MLR.0000000000001344.
6
Changes In Coverage And Access To Dental Care Five Years After ACA Medicaid Expansion.
Health Aff (Millwood). 2020 Nov;39(11):1900-1908. doi: 10.1377/hlthaff.2020.00386.
7
Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed.
Health Aff (Millwood). 2017 Apr 1;36(4):723-732. doi: 10.1377/hlthaff.2016.0877.
8
Effects of Medicaid expansion on self-reported use of dental services in socioeconomically vulnerable subgroups.
J Public Health Dent. 2022 Sep;82(4):395-405. doi: 10.1111/jphd.12473. Epub 2021 Aug 31.
9
Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.
J Gen Intern Med. 2018 Sep;33(9):1495-1497. doi: 10.1007/s11606-018-4537-0. Epub 2018 Jun 25.
10
Disparities in oral health and access to care: findings of national surveys.
Ambul Pediatr. 2002 Mar-Apr;2(2 Suppl):141-7. doi: 10.1367/1539-4409(2002)002<0141:diohaa>2.0.co;2.

引用本文的文献

1
Adopting a Comprehensive Approach to Ensure Effective Delivery of Oral Healthcare Services among Elderly.
J Int Soc Prev Community Dent. 2025 Jun 30;15(3):296-299. doi: 10.4103/jispcd.jispcd_28_25. eCollection 2025 May-Jun.
2
Medicare Advantage Dental Benefits: Comprehensive Coverage Available In Fewer Than Half Of US Counties.
Health Aff (Millwood). 2025 Jun;44(6):693-701. doi: 10.1377/hlthaff.2024.01478.
3
Medicaid Unwinding Experiences in Dual-Eligible Older Adults.
JAMA Health Forum. 2025 Jan 3;6(1):e244692. doi: 10.1001/jamahealthforum.2024.4692.
4
Exploring the association between dental insurance coverage and dental care utilization and oral health among elderly Ontarians.
J Public Health Dent. 2025 Mar;85(1):92-101. doi: 10.1111/jphd.12657. Epub 2025 Jan 2.
5
Social Relationships and Tooth Loss in Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis.
Community Dent Oral Epidemiol. 2025 Aug;53(4):337-346. doi: 10.1111/cdoe.13011. Epub 2024 Oct 22.
6
The Effects of the Expansion of Dental Care Coverage for the Elderly.
Healthcare (Basel). 2024 Sep 29;12(19):1949. doi: 10.3390/healthcare12191949.
7
Association between the COVID-19 outbreak and opioid prescribing by U.S. dentists.
PLoS One. 2023 Nov 2;18(11):e0293621. doi: 10.1371/journal.pone.0293621. eCollection 2023.
8
Dental Services Use: Medicare Beneficiaries Experience Immediate And Long-Term Reductions After Enrollment.
Health Aff (Millwood). 2023 Feb;42(2):286-295. doi: 10.1377/hlthaff.2021.01899.
9
Impact of Medicaid dental coverage expansion on self-reported tooth loss in low-income adults.
J Am Dent Assoc. 2022 Sep;153(9):839-847. doi: 10.1016/j.adaj.2022.03.003. Epub 2022 May 3.
10
Effects of a Medicaid dental coverage "cliff" on dental care access among low-income Medicare beneficiaries.
Health Serv Res. 2023 Jun;58(3):589-598. doi: 10.1111/1475-6773.13981. Epub 2022 Apr 9.

本文引用的文献

1
Dental, Vision, And Hearing Services: Access, Spending, And Coverage For Medicare Beneficiaries.
Health Aff (Millwood). 2020 Feb;39(2):297-304. doi: 10.1377/hlthaff.2019.00451.
2
Oral health disparities: Racial, language and nativity effects.
SSM Popul Health. 2019 Jun 21;8:100436. doi: 10.1016/j.ssmph.2019.100436. eCollection 2019 Aug.
3
Oral health trends for older Americans.
J Am Dent Assoc. 2019 Aug;150(8):714-716. doi: 10.1016/j.adaj.2019.05.026.
4
Tooth Loss Increases the Risk of Diminished Cognitive Function: A Systematic Review and Meta-analysis.
JDR Clin Trans Res. 2016 Apr;1(1):10-19. doi: 10.1177/2380084416633102.
5
Diversity in the use of specialized dental services by older adults in the United States.
J Public Health Dent. 2019 Mar;79(2):160-174. doi: 10.1111/jphd.12309. Epub 2019 Feb 4.
6
Changes in Older Adults' Oral Health and Disparities: 1999 to 2004 and 2011 to 2016.
J Am Geriatr Soc. 2019 Jun;67(6):1152-1157. doi: 10.1111/jgs.15777. Epub 2019 Jan 30.
7
Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014.
J Am Dent Assoc. 2019 Jan;150(1):9-23.e3. doi: 10.1016/j.adaj.2018.09.010. Epub 2018 Nov 29.
8
Racial/Ethnic Minority Older Adults' Perspectives on Proposed Medicaid Reforms' Effects on Dental Care Access.
Am J Public Health. 2017 May;107(S1):S65-S70. doi: 10.2105/AJPH.2016.303640. Epub 2017 Jun 22.
9
A national imperative: Oral health services in Medicare.
J Am Dent Assoc. 2017 May;148(5):281-283. doi: 10.1016/j.adaj.2017.03.004.
10
Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed.
Health Aff (Millwood). 2017 Apr 1;36(4):723-732. doi: 10.1377/hlthaff.2016.0877.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验