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Place of residence affects routine dental care in the intellectually and developmentally disabled adult population on Medicaid.

ABSTRACT: OBJECTIVE: To compare the likelihood of intellectually and developmentally disabled (ID/DD) adults receiving a dental cleaning across places of residence. DATA SOURCES: Medicaid and Minnesota's Medicaid Management Information System (MMIS) databases. STUDY DESIGN: All adults with DD assessments in MMIS in 2001-2002. DATA EXTRACTION METHODS: All completed DD assessments in 2001-2002 linked to Medicaid utilization data for same recipients for same years. CONCLUSIONS: The most disabled individuals are generally least likely to receive a dental cleaning. Individuals living in their own or a family home are less likely to receive the procedure than those living in ICF/MRs or a group home, even after controlling for disability, with those living in a group home falling in between ICF/MR and own/family home residents. The level of preventive dental care that ID/DD adults receive in community settings may be inadequate, particularly for persons living in own homes or with family.

SUBMITTER: Bershadsky J

PROVIDER: S-EPMC2965510 | biostudies-other | 2010 Oct

REPOSITORIES: biostudies-other

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Place of residence affects routine dental care in the intellectually and developmentally disabled adult population on Medicaid.

Bershadsky Julie J Kane Robert L RL

Health services research 20101001 5 Pt 1

<h4>Objective</h4>To compare the likelihood of intellectually and developmentally disabled (ID/DD) adults receiving a dental cleaning across places of residence.<h4>Data sources</h4>Medicaid and Minnesota's Medicaid Management Information System (MMIS) databases.<h4>Study design</h4>All adults with DD assessments in MMIS in 2001-2002.<h4>Data extraction methods</h4>All completed DD assessments in 2001-2002 linked to Medicaid utilization data for same recipients for same years.<h4>Conclusions</h4 ...[more]

PMID: 20609018

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Project description:BackgroundThe relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases.MethodThis study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes) using polychotomous conditional logistic regression.ResultsAsthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99) for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model.ConclusionsThere is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained in this population-based matched case-control study.

Dataset Information

Place of residence affects routine dental care in the intellectually and developmentally disabled adult population on Medicaid.

Publications

Place of residence affects routine dental care in the intellectually and developmentally disabled adult population on Medicaid.

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