How many americans lack access to dental care?
1/3
Who doesn't have access to health care?
Rural communities
Eldery � institutionalized
Low income medicaid
Low income disabled
Components of access
Dental need
Barriers/mediators
Utilization
Oral health status
What do most dentists equate with components of access?
Utilization
What is considered under utilization component?
Provider type
Setting
Purpose
Continuity of care
Quality of care
What is considered under dental need component?
Perceived need
Demand for care
What is considered under barriers/mediators component?
Structural
Financial
Personal/cultural
What is considered under OH status components?
Morbidity
Mortality
Quality of life
How do you measure access
Realized
�how many people received dental care
Potential access
�if i want/need care can i get it
Does IMOM represent access?
Depends on individual
What are different philosophies about access?
Utiliarianism
Egalitarianism
Prioritarianism
Rule of rescue
Utilitarianism
Need to max benefits to society
More concerned about society that indiviuals
Look at overall benefit outweighing cost
Egalitarianism
Equal opportunity to access
Ie. Organ donor list
Prioritarianism
Prioritize the worst off and people who will see the most benefit
This is what the US does a lot
We prioritize children, CHIP
Does not prioritize elderly
Rule of rescue
Save those facing death
See this in US a lot
End of life situations
Why do we have to ration healthcare?
Need is limitless and resources are not
Who decides what access looks like?
Government
Profession
You
No one
Is it unethical to be uncharitable?
No
How much does govt pay for direct health care services?
1/3
How much does govt pay for dental care in US?
12%
What's important trend in dental care?
Since 90's the amount of dental care paid by medicare has increased from 2% to 12%
Where are dentists seeing an increase of their income from?
People with medicaid
T/F: Increasingly we see a steady decline in health insurance and dental care.
True
Why do we evaluate DWP?
Fed requirement
Accountability
Promote continuous improvement
Transparency
How much does iowa spend on medicaid benefits annually?
5 billion
What group of people does iowa medicaid spend the most on?
Disabled (44% of spending in Iowa)
How much did iowa spend on medicaid dental benefits in 2016?
57 million
What is trend in dental expenditures?
...
Kids utilization increasing/decreasing over the past 15 years?
Increasing
Older adults utilization increasing/decreasing over the past 15 years?
Increasing but just the rich older adults
What is the trend of concern in utilization?
Working age adults have a steady declined in utilization
Why has there been a steady decline in working adults utilizing dental care?
Tied to employee sponsored insurance benefits�less people with this
No money saved and cost is high
#1 reason adults don't see the dentist
Cost
Other reasons people don't go to dentist
Cost
Insurance didn't cover
Afraid
Too busy
Who's responsibility is to to provide access?
Dental professionals are not expected to provide free services
Dental therapy movement in us
California,
Alaska
Minnesota
Iowa
Kentucky
Massachusettes
Midlevel providres
B/w dentist and dental assistant or b/w
Pdentist and hygienist
Pt may not accept care from midlevel providers
Unanticipated tx complexity of med emergencies
Pracitice in underserved areas not guaranteed
Concern with dental thearpy
Two tiered system