Lisa Simon (
Zirui Song, Harvard University and Massachusetts General Hospital, Boston, Massachusetts.
Health Aff (Millwood). 2023 Feb;42(2):286-295. doi: 10.1377/hlthaff.2021.01899.
Traditional Medicare does not cover routine dental care, but little is known about transitions in dental outcomes upon reaching Medicare eligibility at age sixty-five. Using data from the 2010-19 Medical Expenditure Panel Surveys, we examined dental insurance, utilization, and outcomes among US adults before and after age sixty-five, using a regression discontinuity design and segmented regression analysis. Among 97,108 US adults representing a weighted population of 104,787,300 people, complete edentulism, or the loss of all teeth, increased by 4.8 percentage points at age sixty-five, and the percentage of people receiving restorative dental care decreased by 8.7 percentage points. Enrollment in Medicare Advantage, which may offer a dental benefit, was not associated with greater use of dental services relative to traditional Medicare, and Medicare Advantage enrollees had a significantly larger drop in dental spending from private insurance at age sixty-five than traditional Medicare enrollees. Expanding Medicare to cover dental services may help counteract these effects among all enrollees.
传统的医疗保险不涵盖常规的牙科护理,但对于 65 岁达到医疗保险资格后牙科护理结果的转变知之甚少。本研究使用 2010-19 年医疗支出面板调查的数据,采用回归不连续性设计和分段回归分析,在年龄 65 岁之前和之后,研究了美国成年人的牙科保险、利用情况和结果。在代表 10478.73 万人的 97108 名美国成年人中,65 岁时完全无牙(即所有牙齿缺失)的比例增加了 4.8 个百分点,接受修复性牙科护理的比例下降了 8.7 个百分点。与传统的医疗保险相比,医疗保险优势计划(可能提供牙科福利)的参与与更多的牙科服务使用并没有关联,并且医疗保险优势计划的参与者在 65 岁时从私人保险转为医疗保险的牙科支出明显高于传统医疗保险的参与者。扩大医疗保险以涵盖牙科服务可能有助于所有参保人抵消这些影响。