National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (6)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Caregiving (1)
- Children/Adolescents (5)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Decision Making (1)
- (-) Dental and Oral Health (20)
- Disparities (2)
- Elderly (6)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Utilization (3)
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- Health Literacy (2)
- Health Services Research (HSR) (2)
- Medicaid (6)
- Medical Expenditure Panel Survey (MEPS) (4)
- Medicare (1)
- Medication (3)
- Nursing Homes (2)
- Opioids (1)
- Outcomes (1)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient Safety (2)
- Practice Patterns (2)
- Prevention (3)
- Provider (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (3)
- Urban Health (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 20 of 20 Research Studies DisplayedShenkman 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)
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
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
Smith W, Brach C, Horowitz AM
AHRQ Author: Brach C
Poor oral health literacy: why nobody understands you.
The authors examined the mistaken interpretation of the word “individuals” to be limited almost exclusively to citizens and patients. They identified gaps in knowledge, understanding, and practices regarding caries prevention among the public and all provider groups.
AHRQ-authored.
Citation: Smith W, Brach C, Horowitz AM .
Poor oral health literacy: why nobody understands you.
J Dent Hyg 2015 Feb;89 Suppl 1:36-8.
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Keywords: Dental and Oral Health, Health Literacy, Prevention
Kranz AM, Rozier RG, Preisser JS
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
To understand continuity of oral health services for Medicaid-enrolled children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, the researchers examined the time to a dentist visit after a child’s third birthday. They found that children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
Matern Child Health J 2015 Jan;19(1):196-203. doi: 10.1007/s10995-014-1510-3..
Keywords: Access to Care, Children/Adolescents, Community-Based Practice, Dental and Oral Health, Medicaid