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首页> 外文期刊>Journal of public health dentistry >Health insurance status is associated with periodontal disease progression among Gullah African-Americans with type 2 diabetes mellitus.
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Health insurance status is associated with periodontal disease progression among Gullah African-Americans with type 2 diabetes mellitus.

机译：健康保险状况与Gullah非洲裔美国人的牙周病进展有关，患有2型糖尿病。

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OBJECTIVES: Assess periodontal disease progression among GullahAfrican Americans with type 2 diabetes mellitus (T2DM) according to health insurance coverage. METHODS: From an ongoing clinical trial among T2DM Gullah, we extracted a cohort that was previously enrolled in a cross-sectional study (N=93). Comparing prior exam to trial initiation, total tooth sites/person with periodontal disease progression events [evaluated separately: 2+ mm of clinical attachment loss (CAL), 2+ mm increased periodontal probing depths (PPD), bleeding on probing (BOP) emergence] were evaluated according to health insurance coverage using regression techniques appropriate for data with different counts of potential events per subject (varying tooth sites available). We used negative binomial regression techniques to account for overdispersion and fit multivariable models that also included baseline glycemic control (poor: glycated hemoglobin > OR =7 percent, well: glycated hemoglobin <7 percent), history of established periodontitis, age, gender, body mass index, annual income, and oral hygiene behaviors. Final models included health insurance status, other significant predictors, and any observed confounders. RESULTS: Privately insured were most prevalent (41.94 percent), followed by uninsured (23.66 percent), Medicare (19.35 percent), and Medicaid (15.05 percent). Those with poor glycemic control (65.59 percent) were more prevalent than well-controlled (34.41 percent). CAL events ranged from 0 to 58.8 percent tooth sites/ person (11.83 +/- 12.44 percent), while PPD events ranged from 0 to 44.2 percent (8.66 +/- 10.97 percent) and BOP events ranged from 0 to 95.8 percent (23.65 +/- 17.21 percent). Rates of CAL events were increased among those who were uninsured [rate ratio (RR) = 1.75, P = 0.02], Medicare-insured (RR = 1.90, P = 0.03), and Medicaid-insured (RR = 1.89, P = 0.06). CONCLUSIONS: Increased access to health care, including dental services, may achieve reduction in chronic periodontal disease progression (as determined by CAL) for this study population. These results are very timely given the March 2010 passing of the US healthcare reform bills.
机译：目的：根据健康保险覆盖率评估患有2型糖尿病（T2DM）的Gullahafrican美国人之间的牙周病进展。方法：从T2DM Gullah之间的正在进行的临床试验中，我们提取了先前注册横断面研究的群组（n = 93）。将先前考试与试验开始，牙齿疾病患者的总牙头位点/人分别进行评估：2毫米的临床附着损失（CAL），2毫米增加牙周探测深度（PPD），探测（BOP）出现出血]根据健康保险覆盖，使用适合于每个受试者的潜在事件数量的数据（不同的牙齿可用的数据）来评估。我们使用了负二项式回归技术来考虑过度分散和适合多变量模型，也包括基线血糖控制（差：糖化血红蛋白>或= 7％，良好：糖化血红蛋白<7％），既定牙周炎的历史，年龄，性别，身体大众指数，年收入和口腔卫生行为。最终模型包括健康保险状态，其他重要预测因子以及任何观察到的混淆。结果：私营保险最普遍（41.94％），其次是未保险（23.66％），Medicare（19.35％）和医疗补助（15.05％）。血糖控制差（65.59％）的人比控制良好（34.41％）更普遍。 CAL事件范围从0到58.8％的牙齿网站/人（11.83 +/- 12.44％），而PPD事件的范围从0到44.2％（8.66 +/- 10.97％），并且BOP事件范围从0到95.8％（23.65 + / - 17.21％）。在未保险的人[率比（RR）= 1.75，P = 0.02]，医疗保险（RR = 1.90，P = 0.03）和医疗保险（RR = 1.89，P = 0.06 ）。结论：增加对医疗保健（包括牙科服务）的获得，可实现慢性牙周病进展的降低（由CAL确定）这项研究人群。鉴于2010年3月通过美国医疗保健改革票据，这些结果非常及时。

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