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Barriers to dental care for children with medical assistance

Stoner, Kevin (2019) Barriers to dental care for children with medical assistance. Master's Thesis, University of Pittsburgh. (Unpublished)

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Disparities in access to dental care between children with private dental insurance and children with Medical Assistance (MA) exist. This was highlighted in the 2000 Surgeon General’s report on Oral Health, and there have been efforts to get more children with MA to the dentist yearly. Since 2009 Medicaid and CHIP are required to provide dental insurance to children enrolled in their plans. This has raised the rates of children with MA who see a dentist each year from 36% to ~50%. This is well below the ~90% of children with private dental insurance who see a dentist yearly. This raises the question: why does this disparity exist when children with MA have dental insurance? This study sought to determine if secret shopper surveys and geospatial analysis could be utilized to determine barriers to dental care for children with MA.
Ninety-eight dental practices in Allegheny County were identified as accepting MA, providing access to 205 dentists and 6,839.5 hours of availability each week. Many of these dental practices had incorrect information on Managed Care Organization websites, and some dental practices actively limit when children with MA can be seen.
This study also sought to determine if access by proximity is a barrier. A geospatial analysis was used to determine if children have access to care based on a distance of 15 miles, or 30-minute drive or transit time. This analysis showed that if children rely on public transportation to see a dentist, then children in certain zip codes throughout the county do not have adequate access. An analysis of how dentists and hours would need to be redistributed throughout the county to provide equal access showed that the zip codes with the most children with MA have access to the least number of dentists and hours needed. This was by distance, drive, and transit times.
The public health importance of this study is that secret shopper and geospatial analysis can be used to identify potential barriers to dental care. It identified that proximity may be one of the biggest limiting factors, especially for children who rely on public transportation.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Stoner, KevinKES216@pitt.eduKES2160000-0002-1298-7602
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorRoberts,
Committee MemberTerry,
Committee MemberHershey,
Committee MemberFricke,
Date: 20 June 2019
Date Type: Publication
Defense Date: 4 April 2019
Approval Date: 20 June 2019
Submission Date: 4 April 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 48
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Dental Care, Medical Assistance, Barriers
Date Deposited: 20 Jun 2019 15:42
Last Modified: 20 Jun 2019 15:42

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