ArticlePloS one2020
Longitudinal analysis of cost and dental utilization patterns for older adults in outpatient and long-term care settings in Minnesota.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Costs in dental care: a scoping review of methodologies and trends.BMC oral health · 2025Article
- Geroscience: Aging and Oral Health Research.Advances in dental research · 2023Review
- Factors affecting oral and dental services` utilization among Elderly: a scoping review.BMC oral health · 2023Article
- Barriers and Opportunities to Support the Oral Health of Older Adults: A Rapid Review of Health Policy and Systems.International journal of aging & human development · 2023Review
- Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People.International journal of environmental research and public health · 2022Article
- Costs for Statutorily Insured Dental Services in Older Germans 2012-2017.International journal of environmental research and public health · 2021Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.
methodsRetrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period.
resultsCohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients.
conclusionCosts for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits.
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