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Assessing the contribution of the dental care delivery system to oral health care disparities
Author(s) -
Pourat Nadereh,
Andersen Ronald M,
Marcus Marvin
Publication year - 2014
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/jphd.12064
Subject(s) - medicaid , ethnic group , medicine , dental insurance , dental care , health care , population , family medicine , delivery system , oral health , medline , environmental health , gerontology , political science , law , pharmacology , sociology , anthropology , economics , economic growth
Objectives Existing studies of disparities in access to oral health care for underserved populations often focus on supply measures such as number of dentists. This approach overlooks the importance of other aspects of the dental care delivery system, such as personal and practice characteristics of dentists, that determine the capacity to provide care. This study aims to assess the role of such characteristics in access to care of underserved populations. Methods We merged data from the 2003 C alifornia H ealth I nterview S urvey and a 2003 survey of C alifornia dentists in their M edical S tudy S ervice A reas ( MSSA s). We examined the role of overall supply and other characteristics of dentists in income and racial/ethnic disparities in access, which was measured by annual dental visits and unmet need for dental care due to costs. Results We found that some characteristics of MSSA s, including higher proportions of dentists who were older, white, busy or overworked, and did not accept public insurance or discounted fees, inhibited access for low‐income and minority populations. Conclusions These findings highlight the importance of monitoring characteristics of dentists in addition to traditional measures of supply such as licensed‐dentist‐to‐population ratios. The findings identify specific aspects of the delivery system such as dentists' participation in Medicaid, provision of discounted care, busyness, age, race/ethnicity, and gender that should be regularly monitored. These data will provide a better understanding of how the dental care delivery system is organized and how this knowledge can be used to develop more narrowly targeted policies to alleviate disparities.