National Healthcare Quality and Disparities Report
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- Access to Care (2)
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- Case Study (1)
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- Patient Safety (2)
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- Policy (1)
- Practice Patterns (4)
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- Provider: Physician (1)
- Provider Performance (1)
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- Quality Indicators (QIs) (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedYan CH, Ramanathan S, Suda KJ
Barriers to and facilitators of opioid prescribing by dentists in the United States: a qualitative study.
In this study, a national sample of US dentists was interviewed to understand the barriers and facilitators to opioid prescribing. Findings showed that dentists' opioid decision making is influenced by a range of real-world practice experiences and patient and clinic factors. Recommendations included targeting knowledge gaps in dentistry for education, clinical guidelines, and policy interventions in order to ensure safe and appropriate prescribing of opioids.
AHRQ-funded; HS025177.
Citation: Yan CH, Ramanathan S, Suda KJ .
Barriers to and facilitators of opioid prescribing by dentists in the United States: a qualitative study.
J Am Dent Assoc 2022 Oct;153(10):957-69.e1. doi: 10.1016/j.adaj.2022.05.009..
Keywords: Dental and Oral Health, Opioids, Medication
Lipton BJ, Decker SL, Stitt B
AHRQ Author: Decker SL Manski RJ
Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences.
The purpose of this cross-sectional study was to assess the relationship between the ratio of Medicaid payment rates to dentist charges and children's preventive dental visits, oral health, and school absences. The researchers conducted a difference-in-differences analysis of 15,738 Medicaid-enrolled children and a control group of 16 867 privately insured children aged 6 to 17 years who participated in the 2016-2019 National Survey of Children's Health. The study found that 87% and 48% of Medicaid-enrolled children had at least 1 and at least 2 past-year dental visits, respectively, and 29% had parent-reported excellent oral health. Increasing the fee ratio by was associated with increases in at least 1 and 2 visits and in excellent oral health. Increases in at least 2 visits were larger for Hispanic children than for White children. By weighted baseline estimates, 28% and 15% of Medicaid-enrolled children had at least 4 and at least 7 past-year school absences, respectively. The researchers concluded that Medicaid policies with higher payments were associated with modest increases in children's preventive dental visits and excellent oral health.
AHRQ-authored.
Citation: Lipton BJ, Decker SL, Stitt B .
Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences.
JAMA Health Forum 2022 Sep 2;3(9):e223041. doi: 10.1001/jamahealthforum.2022.3041..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Payment, Policy
Kalenderian E, Lee JH, Obadan-Udoh EM
Development of an inventory of dental harms: methods and rationale.
The authors sought to standardize the language of dental adverse events (AEs). Using a multimodal approach, they developed a broad list of dental AEs in which the AEs were classed into 12 categories, with hard tissue injury being noted frequently. Pain was the unexpected AE that was consistently identified with every modality used.
AHRQ-funded; HS024406.
Citation: Kalenderian E, Lee JH, Obadan-Udoh EM .
Development of an inventory of dental harms: methods and rationale.
J Patient Saf 2022 Sep 1;18(6):559-64. doi: 10.1097/pts.0000000000001033..
Keywords: Dental and Oral Health, Patient Safety, Research Methodologies
Khouja T, Polk DE, Suda KJ
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
The objective of this study was to describe opioid prescribing trends among oral and maxillofacial surgeons (OMFS). The IQVIA Longitudinal Prescription Dataset, 2016-2019, was used to identify prescriptions written by OMFS. The results indicated that while OMFS-prescribed hydrocodone and oxycodone decreased in most states, 12 percent of states showed increases. Tramadol and codeine prescriptions also increased. From these findings, the authors concluded that targeted interventions are warranted in some areas.
AHRQ-funded; HS025177.
Citation: Khouja T, Polk DE, Suda KJ .
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
J Public Health Dent 2022 Sep;82(4):491-94. doi: 10.1111/jphd.12544..
Keywords: Opioids, Medication, Practice Patterns, Orthopedics, Surgery, Dental and Oral Health, Provider: Physician
Khouja T, Zhou J, Gellad WF
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
This study’s objective was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with dental visit and corresponding opioid prescription from 2011 to 2017 within a nationwide commercial claims database was conducted. As per CDC guidelines, opioid overprescribing was defined as >120 morphine milligram equivalents. Of 633,387 visits, 16.6% had POU and 2.6% experienced an adverse outcome. POU was higher when opioids were overprescribed with visits associated with mild pain and those with substance use disorders having the highest risk of both outcomes.
AHRQ-funded; HS025177.
Citation: Khouja T, Zhou J, Gellad WF .
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
Pain 2022 Aug 1;163(8):1571-80. doi: 10.1097/j.pain.0000000000002545..
Keywords: Opioids, Dental and Oral Health, Substance Abuse, Behavioral Health, Practice Patterns, Pain, Medication, Adverse Drug Events (ADE), Adverse Events
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C
AHRQ Author: Harris S
Screening and interventions to prevent dental caries in children younger than five years.
This case study concerns Hispanic parents new to a practice who bring in their two children, two years of age and four months of age, for routine wellness visits. The parents have questions about dental care for their children. Three case study questions are provided along with answers. Bonus digital content provides an information sheet with a Clinical Summary of the USPSTF Recommendation.
AHRQ-authored.
Citation: Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C .
Screening and interventions to prevent dental caries in children younger than five years.
Am Fam Physician 2022 Mar;105(3):299-300..
Keywords: Children/Adolescents, Dental and Oral Health, Screening, Guidelines, Evidence-Based Practice, Case Study
Shenkman E, Tomar S, Manning D
Feasibility and usability of measuring receipt of sealants in 2 states.
In this study, the authors examined the reliability and validity of the Dental Quality Alliance childhood sealant measure under actual use conditions in Texas and Florida. The 2 states provide care for almost 20% of children in Medicaid nationally. They proposed eliminating the caries risk assessment requirement and incorporating a 3-year look-back period to identify already sealed, missing, or restored molars.
AHRQ-funded; U18 HS025298.
Citation: Shenkman E, Tomar S, Manning D .
Feasibility and usability of measuring receipt of sealants in 2 states.
J Am Dent Assoc 2019 Oct;150(10):839-45. doi: 10.1016/j.adaj.2019.05.022..
Keywords: Dental and Oral Health, Children/Adolescents, Quality Measures, Quality of Care
Meyerhoefer CD, Zuvekas SH, Farkhad BF
AHRQ Author: Zuvekas SH
The demand for preventive and restorative dental services among older adults.
This study examined the use of preventive and restorative dental services among older adults. Traditional Medicare does not have dental benefits, and older adults must either be employed, have post-retirement dental benefits or spousal coverage, or enroll in a Medicare Advantage program that includes dental coverage. The authors used 2007-2015 Medical Expenditure Panel Survey and supplemental data on dental care prices to estimate the demand for dental care. Dental service was not sensitive to out-of-pocket prices. Older adults with private dental insurance increased preventive service by 25%, and dental coverage through Medicaid increased basic and major service use by 23% and 36%. Women used dental insurance more than men.
AHRQ-authored.
Citation: Meyerhoefer CD, Zuvekas SH, Farkhad BF .
The demand for preventive and restorative dental services among older adults.
Health Econ 2019 Sep;28(9):1151-58. doi: 10.1002/hec.3921..
Keywords: Medical Expenditure Panel Survey (MEPS), Elderly, Dental and Oral Health, Medicare, Health Insurance, Access to Care
Suda KJ, Calip GS, Zhou J
Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures, 2011 to 2015.
This retrospective cohort study examined the use of antibiotic prophylaxis prescribed before dental procedures with patients who have commercial dental insurance. Data from the Truven insurance network was used for claims from 2009 to 2015. Patients in the study were given an antibiotic prescription 7 days before a dental visit. These patients have an appropriate cardiac diagnosis and the median age was 63 and majority female. The majority of dental visits were classified as diagnostic (70.2%) or and/or preventive (58.8%). There were prevalent comorbidities in some patients including prosthetic joint devices (42.5%) and cardiac conditions at higher risk of adverse outcome from infections (20.9%). It was found that 80.9% of antibiotic prescriptions were deemed to be unnecessary based on guidelines.
AHRQ-funded; HS025177.
Citation: Suda KJ, Calip GS, Zhou J .
Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures, 2011 to 2015.
JAMA Netw Open 2019 May 3;2(5):e193909. doi: 10.1001/jamanetworkopen.2019.3909..
Keywords: Decision Making, Dental and Oral Health, Medication, Practice Patterns, Prevention
Suda KJ, Durkin MJ, Calip GS
Comparison of opioid prescribing by dentists in the United States and England.
The goal of this cross-sectional study was to compare opioid prescribing rates by dentists in the US and England, using data on prescriptions dispensed from outpatient pharmacies and health care settings in 2016 by dentists in both countries. Findings show that the proportion of prescriptions for opioids written by US dentists was 37 times greater than the proportion written by English dentists. US dentists also had a higher number of opioid prescriptions per 1000 population and number of prescriptions per dentist. Dihydrocodeine was the only opioid prescribed by English dentists, while US dentists prescribed a range of opioids containing hydrocodone, codeine, oxycodone, and tramadol, as well as long-acting opioids. The researchers conclude that US dentists adopt measures similar to those used in England to reduce dental opioid prescribing in the United States.
AHRQ-funded; HS025177.
Citation: Suda KJ, Durkin MJ, Calip GS .
Comparison of opioid prescribing by dentists in the United States and England.
JAMA Netw Open 2019 May 3;2(5):e194303. doi: 10.1001/jamanetworkopen.2019.4303..
Keywords: Dental and Oral Health, Medication, Opioids, Pain, Practice Patterns, Provider
Gross AE, Hanna D, Rowan SA
Successful implementation of an antibiotic stewardship program in an academic dental practice.
Researchers created a comprehensive antibiotic stewardship program (ASP) for dental practices. A baseline needs assessment and literature evaluation was conducted by a team of dentists, pharmacists, and physician leaders. An academic dental center in Illinois that is the state’s largest oral health provider for Medicaid recipients was used. After intervention with the ASP, there was a 72.9% decrease in antibiotic prescribing for urgent care visits.
AHRQ-funded; HS025177.
Citation: Gross AE, Hanna D, Rowan SA .
Successful implementation of an antibiotic stewardship program in an academic dental practice.
Open Forum Infect Dis 2019 Mar;6(3):ofz067. doi: 10.1093/ofid/ofz067..
Keywords: Antibiotics, Antimicrobial Stewardship, Dental and Oral Health, Medication, Patient Safety
Abdus S, Decker SL
AHRQ Author: Abdus S, Decker SL
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
AHRQ researchers compared nonemergency dental services use in states with and without Medicaid adult nonemergency dental benefits. Dental use increased in states with the Medicaid dental benefit. Out-of-pocket expenses decreased approximately 19 percent in covered states.
AHRQ-authored.
Citation: Abdus S, Decker SL .
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
J Am Dent Assoc 2019 Jan;150(1):24-33. doi: 10.1016/j.adaj.2018.08.010..
Keywords: Dental and Oral Health, Healthcare Costs, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS)
Beil H, Rozier RG, Preisser JS
Effects of early dental office visits on dental caries experience.
This study determined the association between timing of a first dentist office visit before age 5 and dental disease in kindergarten. It found that children with early dental visits (before age 2) had higher rates of tooth decay than those who had later visits (between ages 3 and 5).
AHRQ-funded; HS018076.
Citation: Beil H, Rozier RG, Preisser JS .
Effects of early dental office visits on dental caries experience.
Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325..
Keywords: Dental and Oral Health, Children/Adolescents, Access to Care, Medicaid, Prevention
Holzer J, Canavan M, Bradley E
County-level correlation between adult obesity rates and prevalence of dentists.
The researchers conducted a study to examine the association between the prevalence of dentists and the rates of adult obesity. They found that having one additional dentist per 10,000 population was associated significantly with a 1-percentage point reduction in the rate of obesity. This effect was significantly larger in counties in which 25 percent of children or more (versus less than 25 percent of children) lived in poverty and in counties that had more primary care physicians per 10,000 population.
AHRQ-funded; HS017589.
Citation: Holzer J, Canavan M, Bradley E .
County-level correlation between adult obesity rates and prevalence of dentists.
J Am Dent Assoc 2014 Sep;145(9):932-9. doi: 10.14219/jada.2014.48.
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Keywords: Dental and Oral Health, Obesity, Risk, Social Determinants of Health
Manski RJ, Cohen LA, Brown E
AHRQ Author: Brown E, Carper KV
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65 years and older in 2009 and looks at trends since 1999. It found that between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased.
Citation: Manski RJ, Cohen LA, Brown E .
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
J Public Health Dent 2014 Sum;74(3):219-26. doi: 10.1111/jphd.12049..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Healthcare Utilization
Kranz AM, Rozier RG, Preisser JS
Preventive services by medical and dental providers and treatment outcomes.
The researchers compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. They concluded that, due to children's increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Preventive services by medical and dental providers and treatment outcomes.
J Dent Res 2014 Jul;93(7):633-8. doi: 10.1177/0022034514536731.
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Keywords: Children/Adolescents, Dental and Oral Health, Patient-Centered Outcomes Research, Prevention, Primary Care
Gibson G, Jurasic MM, Wehler CJ
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
In this paper, the authors hypothesized that after the implementation of a performance measure regarding appropriate fluoride use, veterans at high risk of experiencing caries would require fewer new dental restorations than in the past. They found that, after use of the performance measure for four years, there were 8.6 percent fewer patients needing two or more restorations, a 10.8 percent decrease in the mean number of restorations, and a modest 3.4 percent fewer patients at high risk of experiencing caries who required new restorations after the initial 12-month period.
AHRQ-funded; HS019527.
Citation: Gibson G, Jurasic MM, Wehler CJ .
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
J Am Dent Assoc 2014 May;145(5):443-51. doi: 10.14219/jada.2013.53.
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Keywords: Dental and Oral Health, Healthcare Delivery, Provider Performance, Quality Indicators (QIs), Quality Measures
Meyerhoefer CD, Zuvekas SH, Manski R
AHRQ Author: Zuvekas SH, Manski R
The demand for preventive and restorative dental services.
The authors sought to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. They concluded that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants.
AHRQ-authored.
Citation: Meyerhoefer CD, Zuvekas SH, Manski R .
The demand for preventive and restorative dental services.
Health Econ 2014 Jan;23(1):14-32. doi: 10.1002/hec.2899.
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Keywords: Chronic Conditions, Dental and Oral Health, Health Insurance, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS)