Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

• Główni autorzy: Chaudhari Monica (Autor), Hubbard Rebecca (Autor), Reid Robert J (Autor), Inge Ronald (Autor), Newton Katherine M (Autor), Spangler Leslie (Autor), Barlow William E (Autor)
• Format: Książka
• Wydane: BMC, 2012-07-01T00:00:00Z.
• Hasła przedmiotowe: article
• Dostęp online: Connect to this object online.

Streszczenie

<p>Abstract</p> <p>Background</p> <p>About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes.</p> <p>Methods</p> <p>Data included secondary enrollment and demographic data from Washington Dental Service (WDS) and Group Health Cooperative (GH), clinical data from GH, and dental-utilization data from WDS claims during 2002-2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups.</p> <p>Results</p> <p>We found that adults with diabetes had lower odds of visiting a dentist (OR <b>=</b> 0.74, p <b><</b> 0.001). Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR <b>=</b> 0.77), fillings (OR <b>=</b> 0.80) and crowns (OR <b>=</b> 0.84) (p<b> < </b>0.005 for all) and higher odds of receiving periodontal maintenance (OR <b>=</b> 1.24), non-surgical periodontal procedures (OR <b>=</b> 1.30), extractions (OR <b>=</b> 1.38) and removable prosthetics (OR <b>=</b> 1.36) (p < 0.001 for all).</p> <p>Conclusions</p> <p>Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.</p>

Deskrypcja

10.1186/1472-6831-12-20
1472-6831