Kim Junghwan, Karki Shashank, Brickhouse Tegwyn, Vujicic Marko, Nasseh Kamyar, Wang Changzhen, Zhang Mengxi
Department of Geography, College of Natural Resources and Environment, Virginia Tech, Blacksburg, Virginia, USA.
Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA.
Community Dent Oral Epidemiol. 2025 Feb;53(1):117-124. doi: 10.1111/cdoe.13015. Epub 2024 Oct 30.
To identify vulnerable areas and populations with limited access to dental care in Virginia, the study aimed (1) to calculate travel time and accessibility scores to dental care in Virginia using a transit-based accessibility model for all dental clinics and dental clinics participating in the Medicaid dental program and (2) to estimate factors associated with accessibility to dental clinics participating in the Medicaid dental program in Virginia.
The study used building footprints as origins of transit trips to dental care services (or destinations). The study then computed transit-based origin-destination travel time matrices based on the detailed trip information, including in-vehicle and out-of-vehicle travel time. Accessibility scores were calculated by counting the number of dental clinics that can be reached within 60 min. Regression analysis was used to measure factors associated with accessibility scores to dental clinics participating in Medicaid.
Residents in smaller regions spent longer travel time to dental clinics by public transit compared with those who resided in larger regions. Medicaid participants also faced longer travel time compared with the general population. Residents spent more than three-fourths of the time waiting for public transit and walking to clinics regardless of where they live and what type of insurance they have. Associations between sociodemographic factors and accessibility scores to dental clinics participating in the Medicaid dental program varied across regions.
Disparities in dental care accessibility exist depending on the size of regions and Medicaid participation in Virginia. The disparities in transit-based access to dental clinics and a disproportionate amount of time spent waiting for public transit and walking to dental clinics could be improved through tailored interventions taking into account the sociodemographic and geographic characteristics of each region.
为了确定弗吉尼亚州获得牙科护理机会有限的脆弱地区和人群，该研究旨在：（1）使用基于公共交通的可达性模型，计算弗吉尼亚州所有牙科诊所以及参与医疗补助牙科项目的牙科诊所的牙科护理出行时间和可达性得分；（2）估计与弗吉尼亚州参与医疗补助牙科项目的牙科诊所可达性相关的因素。
该研究将建筑物占地面积作为前往牙科护理服务（或目的地）的公共交通出行起点。然后，研究根据详细的出行信息，包括车内和车外出行时间，计算基于公共交通的起点 - 终点出行时间矩阵。通过计算在60分钟内可到达的牙科诊所数量来计算可达性得分。采用回归分析来衡量与参与医疗补助的牙科诊所可达性得分相关的因素。
与居住在较大地区的居民相比，较小地区的居民乘坐公共交通前往牙科诊所的时间更长。与普通人群相比，医疗补助参与者的出行时间也更长。无论居住在哪里以及拥有何种类型的保险，居民花费超过四分之三的时间等待公共交通和步行前往诊所。社会人口因素与参与医疗补助牙科项目的牙科诊所可达性得分之间的关联因地区而异。
在弗吉尼亚州，牙科护理可达性存在差异，这取决于地区规模和医疗补助参与情况。通过考虑每个地区的社会人口和地理特征进行针对性干预，可以改善基于公共交通前往牙科诊所的差异以及在等待公共交通和步行前往牙科诊所方面花费的不成比例的时间。
