National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (8)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Behavioral Health (1)
- Caregiving (1)
- Case Study (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (9)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- (-) Dental and Oral Health (27)
- Disabilities (1)
- Disparities (3)
- Education (1)
- Elderly (5)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Utilization (3)
- Health Insurance (4)
- Health Literacy (3)
- Health Services Research (HSR) (2)
- Medicaid (8)
- Medical Expenditure Panel Survey (MEPS) (4)
- Medication (3)
- Nursing Homes (2)
- Opioids (3)
- Orthopedics (1)
- Outcomes (1)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient Safety (2)
- Payment (1)
- Policy (1)
- Practice Patterns (2)
- Prevention (2)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (4)
- Research Methodologies (1)
- Rural Health (1)
- Screening (1)
- Substance Abuse (1)
- Surgery (1)
- Urban Health (2)
- Vulnerable Populations (2)
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 25 of 27 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
Burgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Weintraub JA, Zimmerman S, Ward K
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
This paper describes a 2-year cluster randomized trial of Mouth Care Without a Battle (MCWB) that was conducted in nursing homes (NHs) to determine if recommended mouth care practices provided by NH staff could improve residents' oral hygiene and denture outcomes. The investigators found that training NH staff to attend to residents' oral hygiene and denture care had a sustained, favorable impact on residents' oral and denture hygiene after 24 months compared with usual care.
AHRQ-funded; HS022298.
Citation: Weintraub JA, Zimmerman S, Ward K .
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
J Am Med Dir Assoc 2018 Dec;19(12):1086-91. doi: 10.1016/j.jamda.2018.09.036.
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Keywords: Dental and Oral Health, Elderly, Nursing Homes
Yoon S, Odlum M, Lee Y
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
In this study, the investigators applied deep learning algorithms to build correlate models that predicted tooth mobility in a convenience sample of urban Latinos. The authors suggest that their application was useful for gaining insights into the most important modifiable and non-modifiable factors predicting tooth mobility, and maybe useful for guiding targeted interventions in urban Latinos.
AHRQ-funded; HS019853.
Citation: Yoon S, Odlum M, Lee Y .
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
Stud Health Technol Inform 2018;251:241-44..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Yoon S, Choi T, Odlum M
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
In this study, the investigators applied machine learning techniques to a community-based behavioral dataset to build prediction models to gain insights about minority dental health and population aging as the foundation for future interventions for urban Hispanics. Their application of machine learning techniques identified emotional and systemic factors such as chronic stress and health literacy as the strongest predictors of self-reported dental health among hundreds of possible variables.
AHRQ-funded; HS019853.
Citation: Yoon S, Choi T, Odlum M .
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
Stud Health Technol Inform 2018;251:253-56..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Burgette JM, Preisser JS, Weinberger M
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
The purpose of the study was to examine the moderating effect of parents' health literacy (HL) on the effectiveness of North Carolina Early Head Start (EHS) in improving children's dental use. The investigators found that parents in EHS had a higher prevalence of low HL compared to non-EHS parents. Parents' HL did not moderate the relationship between EHS and child dental use, suggesting that EHS results in similar improvements in dental use regardless of parent's HL levels.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
J Public Health Dent 2018 Jun;78(3):257-65. doi: 10.1111/jphd.12269..
Keywords: Caregiving, Children/Adolescents, Dental and Oral Health, Health Literacy
Lipton BJ, Wherry LR, Miller S
AHRQ Author: Lipton BJ, Decker S
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
The researchers estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. They found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks.
AHRQ-authored.
Citation: Lipton BJ, Wherry LR, Miller S .
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
Health Aff 2016 Dec;35(12):2249-58. doi: 10.1377/hlthaff.2016.0865.
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Keywords: Medicaid, Dental and Oral Health, Children/Adolescents, Disparities, Racial and Ethnic Minorities
Horner-Johnson W, Dobbertin K
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. It found that all disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. Further, disparities in care were apparent even when controlling for presence of dental insurance.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K .
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
J Public Health Dent 2016 Sep;76(4):330-39. doi: 10.1111/jphd.12160.
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Keywords: Access to Care, Dental and Oral Health, Disabilities, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Berdahl T, Hudson J, Simpson L
AHRQ Author: Berdahl T, Hudson J
Annual report on children's health care: dental and orthodontic utilization and expenditures for children, 2010-2012.
The researchers examined general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. Overall, 41.9 percent of US children reported an annual dental office-based visit for general (nonorthodontic) dental care.
AHRQ-authored.
Citation: Berdahl T, Hudson J, Simpson L .
Annual report on children's health care: dental and orthodontic utilization and expenditures for children, 2010-2012.
Acad Pediatr 2016 May-Jun;16(4):314-26. doi: 10.1016/j.acap.2016.02.013.
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Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Healthcare Costs, Health Insurance
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations
Weintraub JA, Burgette JM, Chadwick DG
Educating North Carolina's oral health workforce in an evolving environment.
In 2014, North Carolina had 4,681 actively practicing dentists and ranked 47th among US states in dentist-to-population ratio. The need for dentists is increasing as the population grows, and underserved areas persist. This commentary discusses the impact of the state's 2 dental schools and external factors on dental workforce trends.
AHRQ-funded; HS000032.
Citation: Weintraub JA, Burgette JM, Chadwick DG .
Educating North Carolina's oral health workforce in an evolving environment.
N C Med J 2016 Mar-Apr;77(2):107-11. doi: 10.18043/ncm.77.2.107..
Keywords: Dental and Oral Health, Education, Access to Care, Rural Health, Vulnerable Populations
Burgette JM, Lee JY, Baker AD
Is dental utilization associated with oral health literacy?
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL.
AHRQ-funded; HS000032.
Citation: Burgette JM, Lee JY, Baker AD .
Is dental utilization associated with oral health literacy?
J Dent Res 2016 Feb;95(2):160-6. doi: 10.1177/0022034515617457..
Keywords: Dental and Oral Health, Healthcare Utilization, Health Literacy
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Horner-Johnson W, Dobbertin K, Beilstein-Wedel E
Disparities in dental care associated with disability and race and ethnicity.
The purpose of this study was to determine how the combination of disability and race and ethnicity is associated with dental examinations, delays in receiving needed care, and inability to obtain needed care among noninstitutionalized working-age adults in the United States. It found that, compared with non-Hispanic whites, other racial and ethnic groups were less likely to receive annual dental examinations.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K, Beilstein-Wedel E .
Disparities in dental care associated with disability and race and ethnicity.
J Am Dent Assoc 2015 Jun;146(6):366-74. doi: 10.1016/j.adaj.2015.01.024..
Keywords: Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Disparities
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Mody L
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
This commentary discusses a study by Juthani-Mehta et al in this issue of Clinical Infectious Diseases that adds more steam to the ongoing controversy of the value of chlorhexidine-based oral care by challenging an earlier study. That study found that the odds of dying from pneumonia in those who did not receive oral care was >3 times that of the group receiving oral care. By contrast, the Juthani-Mehta et al study finds no benefit to chlorhexidine use.
AHRQ-funded; HS019979.
Citation: Mody L .
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
Clin Infect Dis 2015 Mar 15;60(6):858-9. doi: 10.1093/cid/ciu941..
Keywords: Nursing Homes, Dental and Oral Health, Elderly, Patient Safety
Manski RJ, Moeller JF, Chen H
AHRQ Author: Manski RJ
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
The purpose of this paper is to empirically determine if insurance alone would close the current gaps in dental use and expenditures between insured and uninsured older Americans. Comparing simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured, the authors found that it would close previous gaps in use and expense.
AHRQ-authored.
Citation: Manski RJ, Moeller JF, Chen H .
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
Health Serv Res. 2015 Feb;50(1):117-35. doi: 10.1111/1475-6773.12205..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Health Insurance, Elderly, Healthcare Costs