Nwachukwu Pamela C, Damiano Peter C, Levy Steven, Thomas James C, Shane Dan, Singhal Astha, Dabdoub Shareef M, Reynolds Julie C
College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
College of Public Health, University of Iowa, Iowa City, Iowa, USA.
J Public Health Dent. 2024 Dec;84(4):362-370. doi: 10.1111/jphd.12636. Epub 2024 Jul 30.
Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental Managed Care Organizations (MCOs) in states with more than one. This study examined the variation in participation overall and in predictors of dentist participation between two MCOs in Iowa's Dental Medicaid program.
Data were obtained from a survey of Iowa private practice dentists (n = 1256). Responding general dentists (n = 497) were included in the final analytic sample. Univariate, bivariate, and multivariable logistic regression analyses were conducted to examine demographic and practice characteristics associated with dentist participation (acceptance of new Medicaid patients) between MCOs and by age category.
Among respondents, the proportions accepting new adults with Medicaid were 26% (MCO 1) and 7% (MCO 2); for children, they were 40% (MCO 1) and 11% (MCO 2). For adults, dentists who were too busy (MCO1) and solo practice dentists (MCO2) were positively significantly associated with the acceptance of new patients. For children, group and rural practice dentists, as well as dentists who worked <32 h/week were positively significantly associated with acceptance of new patients with MCO1.
There was considerable variation in dentist-reported acceptance of new adult and child Medicaid patients, and in the factors affecting acceptance of new patients between MCOs in Iowa dental Medicaid. Future studies of Medicaid participation should consider variations by MCO in states with more than one dental MCO so as not to miss important factors affecting Medicaid participation.
牙医参与医疗补助计划是影响医疗补助受益者获得牙科护理的关键因素。现有文献中的一个重要空白是，在有多个医疗补助牙科管理式医疗组织（MCO）的州，各组织之间的参与情况存在差异。本研究调查了爱荷华州牙科医疗补助计划中两个MCO在牙医参与情况的总体差异以及牙医参与的预测因素。
数据来自对爱荷华州私人执业牙医的一项调查（n = 1256）。最终分析样本纳入了做出回应的普通牙医（n = 497）。进行了单变量、双变量和多变量逻辑回归分析，以研究与MCO之间以及按年龄类别划分的牙医参与情况（接受新的医疗补助患者）相关的人口统计学和执业特征。
在受访者中，接受新的成年医疗补助患者的比例，MCO 1为26%，MCO 2为7%；接受新的儿童医疗补助患者的比例，MCO 1为40%，MCO 2为11%。对于成年人，太忙的牙医（MCO1）和个体执业牙医（MCO2）与接受新患者呈显著正相关。对于儿童，团体和农村执业牙医以及每周工作<32小时的牙医与MCO1接受新患者呈显著正相关。
在爱荷华州牙科医疗补助中，牙医报告的接受新的成年和儿童医疗补助患者的情况以及影响接受新患者的因素在MCO之间存在相当大的差异。未来关于医疗补助参与情况的研究应考虑在有多个牙科MCO的州中各MCO之间的差异，以免遗漏影响医疗补助参与的重要因素。
