Evidence map›Paper›PMID 34103017›Full record

Trial reportBMC health services research2021

Impacts of innovation in dental care delivery and payment in Medicaid managed care for children and adolescents.

Douglas A Conrad, Peter Milgrom, Yuxian Du, Joana Cunha-Cruz, Sharity Ludwig, R Mike Shirtcliff

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Douglas A ConradDepartment of Health Services, School of Public Health, University of Washington, Box 357660, Seattle, WA, USA.
Peter MilgromDepartment of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA. dfrc@uw.edu.
Yuxian DuFred Hutchison Cancer Research Center, Seattle, WA, USA.
Joana Cunha-CruzDepartment of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA.
Sharity LudwigAdvantage Dental Services LLC, Redmond, OR, USA.
R Mike ShirtcliffRMS Dental Director, Inc, 6860 Thunderbird Ct., Redmond, OR, USA.
University of Washington · USFred Hutch Cancer Center · USRegenerative Medical Solutions (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe evaluated a 14-county quality improvement program of care delivery and payment of a dental care organization for child and adolescent managed care Medicaid beneficiaries after 2 years of implementation.

methodsCounties were randomly assigned to either the intervention (PREDICT) or control group. Using Medicaid administrative data, difference-in-difference regression models were used to estimate PREDICT intervention effects (formally, "average marginal effects") on dental care utilization and costs to Medicaid, controlling for patient and county characteristics.

resultsAverage marginal effects of PREDICT on expected use and expected cost of services per patient (child or adolescent) per quarter were small and insignificant for most service categories. There were statistically significant effects of PREDICT (p < .05), though still small, for certain types of service: (1) Expected number of diagnostic services per patient-quarter increased by .009 units; (2) Expected number of sealants per patient-quarter increased by .003 units, and expected cost by $0.06; (3) Total expected cost per patient-quarter for all services increased by $0.64. These consistent positive effects of PREDICT on diagnostic and certain preventive services (i.e., sealants) were not accompanied by increases in more costly service types (i.e., restorations) or extractions.

conclusionThe major hypothesis that primary dental care (selected preventive services and diagnostic services in general) would increase significantly over time in PREDICT counties relative to controls was supported. There were small but statistically significant, increases in differential use of diagnostic services and sealants. Total cost per beneficiary rose modestly, but restorative and dental costs did not. The findings suggest favorable developments within PREDICT counties in enhanced preventive and diagnostic procedures, while holding the line on expensive restorative and extraction procedures.

Indexed as

Dental Care for ChildrenMedicaidAdolescentChildDelivery of Health CareHumansManaged Care ProgramsPreventive Health ServicesPrimary Health CareUnited StatesHub and spoke modelInnovationMedicaidValue-based payment

Identifiers

PMID34103017
PMCPMC8188686
OpenAlexW3170802651

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.