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Racial differences in treatment preferences: oral health as an example
Author(s) -
Tilashalski Ken R.,
Gilbert Gregg H.,
Boykin Michael J.,
Litaker Mark S.
Publication year - 2007
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2006.00661.x
Subject(s) - oral health , medicine , psychology , family medicine
Rationale, aims and objectives Recent analyses from the Florida Dental Care Study found that response to a hypothetical scenario at baseline strongly predicted: (a) tooth loss during follow‐up; and (b) subsequent receipt of either a dental extraction or Root Canal Therapy (RCT). The scenario (‘CHOICE’) required choosing either to: (1) extract the tooth before even knowing the cost of treatments; (2) extract, but after knowing the cost of all treatments; or (3) have RCT despite knowing costs. Objective The purpose of this study was to identify factors associated with CHOICE and quantify their effects. Methods As part of the baseline phase of the study, 873 subjects with at least one tooth and who were 45 years or older participated for an interview and dental examination. A multinomial multivariable regression of CHOICE quantified effects due to hypothesized predictors. Results CHOICE was strongly associated with race (African‐Americans were significantly less likely to choose RCT). Results from the multivariable regression suggest that the race effect could be explained by racial differences in patient preference, treatment acceptability and ability to afford treatment. Conclusions There were substantial racial differences in treatment preference even in this hypothetical scenario where racial differences in patient–provider interaction and clinical factors were not relevant. Certain predisposing and enabling variables explained these racial differences in treatment preference.