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首页> 外文期刊>BMC Health Services Research >Impacts of innovation in dental care delivery and payment in Medicaid managed care for children and adolescents
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Impacts of innovation in dental care delivery and payment in Medicaid managed care for children and adolescents

机译：创新对儿童和青少年医疗保健管理和青少年的牙科护理和付款的影响

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We evaluated a 14-county quality improvement program of care delivery and payment of a dental care organization for child and adolescent managed care Medicaid beneficiaries after 2 years of implementation. Counties were randomly assigned to either the intervention (PREDICT) or control group. Using Medicaid administrative data, difference-in-difference regression models were used to estimate PREDICT intervention effects (formally, “average marginal effects”) on dental care utilization and costs to Medicaid, controlling for patient and county characteristics. Average marginal effects of PREDICT on expected use and expected cost of services per patient (child or adolescent) per quarter were small and insignificant for most service categories. There were statistically significant effects of PREDICT (p??.05), though still small, for certain types of service: These consistent positive effects of PREDICT on diagnostic and certain preventive services (i.e., sealants) were not accompanied by increases in more costly service types (i.e., restorations) or extractions. The major hypothesis that primary dental care (selected preventive services and diagnostic services in general) would increase significantly over time in PREDICT counties relative to controls was supported. There were small but statistically significant, increases in differential use of diagnostic services and sealants. Total cost per beneficiary rose modestly, but restorative and dental costs did not. The findings suggest favorable developments within PREDICT counties in enhanced preventive and diagnostic procedures, while holding the line on expensive restorative and extraction procedures.
机译：我们在执行2年后，我们评估了一个14县的护理送货和支付牙科护理组织的牙科护理组织。县被随机分配给干预（预测）或对照组。使用医疗补助行政数据，差异差异回归模型用于估计预测干预效果（正式，“平均边际效应”）对医疗补助的牙科护理利用和成本，控制患者和县特征。每季度每季度的预期使用和预期服务费用和预期服务费用的平均边际效应对于大多数服务类别，每季度每季度（儿童或青少年）都很小而微不足道。预测（p？＆＆ 05）统计上存在统计学上显着的影响更昂贵的服务类型（即修复）或提取。主要假设（主要的牙科护理（一般选定的预防服务和诊断服务）将随着时间的推移而显着增加，以预测相对于控制的统计数据得到支持。诊断服务和密封剂的差异使用较小但统计学显着。每个受益人的总费用适度上涨，但恢复性和牙齿成本没有。调查结果表明，预测预防和诊断程序中的预测县内有利于发展，同时持有昂贵的恢复性和提取程序。

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