J Am Dent Assoc. 2022 Jul;153(7):659-667. doi: 10.1016/j.adaj.2022.01.005. Epub 2022 Mar 11.
Although Medicaid expansion aims to eliminate financial barriers to health care for low-income people in the United States, health care accessibility cannot be guaranteed without clinicians who provide health care to Medicaid recipients. This study examined the characteristics of Indiana dentists that are associated with the likelihood of participating in Medicaid after expansion in 2015.
This study included Indiana-licensed dentists who renewed their licenses in 2018 and provided supplemental data elements related to demographics, education and training, and professional characteristics. Dentists' Medicaid engagement behavior was categorized on the basis of when claims were submitted from 2014 through 2017. Statistical analyses included the χ test and generalized multinomial logit model.
Overall, 2,037 Indiana-licensed dentists were included in the study. Of these, 802 (39.4%) were continually active in Medicaid during the study period, and 116 (5.7%) became active after expansion. Dentists had a greater likelihood of engaging in Medicaid after expansion if they were female, specialized in oral and maxillofacial surgery, practiced in a group practice, and were located in a rural county.
This study shows that dentists with certain demographic and practice characteristics had a greater likelihood of participation in Indiana Medicaid after expansion in 2015. Several findings from this study are consistent with previous research regarding the emerging trends in workforce diversity and show the impact of expansion policies on the dental safety net.
This study presents an effective framework for the use of administrative and regulatory data sources for state-level analysis of the Medicaid safety net.
尽管医疗补助计划旨在消除美国低收入人群获得医疗保健的经济障碍，但如果没有为医疗补助受助人提供医疗服务的临床医生，就无法保证医疗保健的可及性。本研究调查了与 2015 年扩张后参与医疗补助的可能性相关的印第安纳州牙医的特征。
本研究包括在 2018 年续签许可证的印第安纳州持照牙医，并提供与人口统计学、教育和培训以及专业特征相关的补充数据元素。根据 2014 年至 2017 年期间提交的索赔情况，将牙医的医疗补助参与行为分为几类。统计分析包括 χ 检验和广义多项逻辑回归模型。
总体而言，本研究共纳入 2037 名印第安纳州持照牙医。其中，802 名（39.4%）在研究期间一直持续参与医疗补助，116 名（5.7%）在扩张后开始参与。如果牙医是女性、专门从事口腔颌面外科、在团体实践中执业并且位于农村县，则在扩张后参与医疗补助的可能性更大。
本研究表明，具有某些人口统计学和实践特征的牙医在 2015 年扩张后更有可能参与印第安纳州的医疗补助。本研究的一些发现与之前关于劳动力多样性新兴趋势的研究一致，并显示了扩张政策对牙科安全网的影响。
本研究为使用行政和监管数据源进行州级医疗补助安全网分析提供了有效的框架。
