Evidence map›Paper›PMID 38647184›Full record

Observational studyCommunity dentistry and oral epidemiology2024

Barriers to dental utilization among Medicaid-enrolled young children from primary care practices in Northeast Ohio.

David Selvaraj, Neel Agarwal, Jeffrey M Albert, Suchitra Nelson

Abstract readObservational Study
In one paragraph

Observational study in Community dentistry and oral epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

4 authors.

David SelvarajDepartment of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA.
Neel AgarwalDepartment of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA.
Jeffrey M AlbertDepartment of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Suchitra NelsonDepartment of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA.ORCID 0000-0002-1204-7020

Funding

COORDINATING CENTER TO HELP ELIMINATE/REDUCE ORAL HEALTH INEQUALITIES IN CHILDRENU01DE025507 · NIDCR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GANSKY, STUART A · 2015 to 2020
$11.9M
Multi-Level Interventions to Reduce Caries Disparities in Primary Care SettingsUH3DE025487 · NIDCR · CASE WESTERN RESERVE UNIVERSITY · PI NELSON, SUCHITRA S. · 2017 to 2021
$5.6M
NIDCR NIH HHS U01 DE025507NIDCR NIH HHS UH3 DE025487
6 · The paper itself

Abstract

objectivesTo evaluate the individual and community factors that contribute to dental utilization among young children on Medicaid utilizing the Anderson Model and the Socio-Ecological Framework.

methodsThis observational cross-sectional study was conducted using baseline data (socio-demographics, clinical dental need) from a cluster-randomized hybrid effectiveness-implementation trial among 1021 child-parent dyads recruited from primary care practices across northeast Ohio. The baseline data were then linked to dental Medicaid claims data (categorized as any dental visit, volume, and type in the past 12 months) and ICD-10 codes from the child's EHR data (individual-level) together with Dental Health Provider Shortage Area (HPSA) status and Area Deprivation Index (ADI) which were obtained at the neighbourhood-level using home address of each dyad (community-level). Multivariable analyses using generalized estimating equations (GEE) accounted for clustering by practice, and models included individual-level alone, and individual + community-level factors to evaluate their effects on dental utilization.

resultsMedicaid claims data indicated that among the 1021 children (mean age: 4.3 ± 1.1 years; 54.4% males; 43.8% Black, Non-Hispanic), a majority of children were seeing the dentist at least once a year by the age of 4 (56.1%). The mean ADI of their neighbourhoods was 109.22 (20.2) and 27.5% lived in a HPSA area. The GEE analyses revealed that individual factors such as older children, parents being married, and continuous Medicaid enrollment were associated with significantly higher dental utilization. Among community factors, being in a HPSA had an OR = 1.53 (CI: 1.03, 2.27) associated with higher dental utilization.

conclusionsBeing in a HPSA was associated with higher dental utilization possibly due to dentists or safety net dental clinics in these areas accepting Medicaid-eligible children.

Indexed as

Dental Care for ChildrenHealth Services AccessibilityMedicaidPrimary Health CareChild, PreschoolCross-Sectional StudiesFemaleHumansMaleOhioUnited Statesdental services researchMedicaidpediatric dentistrypolicypublic health

Identifiers

PMID38647184
PMCPMC11371537

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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.