Texas First Dental Home: A Snapshot after Five Years.
Notice bibliographique
Résumé
BACKGROUND: Early caries is still the most prevalent disease of childhood. Its incidence continues to be high, despite recent progress in the amount of untreated caries. The disease is more prevalent in low socio-economic and minority groups. To address this issue, in 2008 Texas implemented the First Dental Home Program for Medicaid children from 6 to 35 months old. The program consists in providing up to 10 preventive and oral health education visits to children very early in life. A specific dental visit code and a bundled payment of $94 were offered to insure adequate dental provider participation. Little is known about the program results to date. This paper evaluates program development at 5 years. METHODS: Two data sets on first dental home patients and providers were obtained from the Texas Department of Health Services. The data cover a 5-year period (3rd quarter of 2008 to end of 2nd quarter 2013). Program participants were geocoded and their distribution was compared to dental underserved areas. Program uptake over time and the relationship between provider and patient locations were also evaluated. RESULTS: The program covered 440,191 children between September 1st, 2011 and February 28th, 2013. All but two counties in Texas had at least one patient enrolled in the program. As expected, program uptake was higher in highly populated and economically disadvantaged counties. Forty-five percent of Texas licensed dentists participated in the program. The number of dental providers certified to provide first dental home services was highly correlated with the number of patients enrolled in the program (r = 0.893). The number of children participating in the program was between 20.4% and 23%. 29.7% of the first dental home patients had only one visit while only 17.1% had five or more visits. The number of patients and the number of visits per patient peaked at the end of 2011 and flatten thereafter. CONCLUSION: Many children benefited from the program since its rollout. However, despite considerable financial resources and dental provider participation, the uptake of the first dental home program by Medicaid beneficiaries could be improved. Moreover, those who participate do not always take full advantage of the program. Without adequate participation, the desired outcomes of the program may not materialize. Additional efforts to catalyze program development and on-going evaluation may be needed.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».