Longitudinal analysis of cost and dental utilization patterns for older adults in outpatient and long-term care settings in Minnesota
Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to descri...
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| Published in | PloS one Vol. 15; no. 5; p. e0232898 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Public Library of Science
14.05.2020
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| Abstract | Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.
Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period.
Cohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients.
Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. |
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| AbstractList | Background Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Methods Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period. Results Cohort mean age was 74 years (range = 55–104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9–19 teeth), 6% had severe tooth loss (1–8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1–19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients. Conclusion Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. Background Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Methods Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period. Results Cohort mean age was 74 years (range = 55–104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9–19 teeth), 6% had severe tooth loss (1–8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1–19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients. Conclusion Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period. Cohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients. Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. BACKGROUNDDental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.METHODSRetrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period.RESULTSCohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients.CONCLUSIONCosts for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period. Cohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients. Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits. |
| Audience | Academic |
| Author | Prosa, Brenda Pierce, Ian Orozco, Mario Asgari, Padideh Finlayson, Tracy L Aronoff-Spencer, Eliah Smith, Barbara J Helgeson, Michael Norman, Gregory |
| AuthorAffiliation | 3 West Health Institute, San Diego, California, United States of America 1 Apple Tree Dental, Mounds View, Minnesota, United States of America 2 School of Public Health, San Diego State University, San Diego, California, United States of America 4 University of California San Diego, San Diego, California, United States of America University of Utah, UNITED STATES |
| AuthorAffiliation_xml | – name: 4 University of California San Diego, San Diego, California, United States of America – name: 2 School of Public Health, San Diego State University, San Diego, California, United States of America – name: 1 Apple Tree Dental, Mounds View, Minnesota, United States of America – name: University of Utah, UNITED STATES – name: 3 West Health Institute, San Diego, California, United States of America |
| Author_xml | – sequence: 1 givenname: Barbara J surname: Smith fullname: Smith, Barbara J organization: Apple Tree Dental, Mounds View, Minnesota, United States of America – sequence: 2 givenname: Michael surname: Helgeson fullname: Helgeson, Michael organization: Apple Tree Dental, Mounds View, Minnesota, United States of America – sequence: 3 givenname: Brenda surname: Prosa fullname: Prosa, Brenda organization: Apple Tree Dental, Mounds View, Minnesota, United States of America – sequence: 4 givenname: Tracy L orcidid: 0000-0003-2457-4183 surname: Finlayson fullname: Finlayson, Tracy L organization: School of Public Health, San Diego State University, San Diego, California, United States of America – sequence: 5 givenname: Mario surname: Orozco fullname: Orozco, Mario organization: West Health Institute, San Diego, California, United States of America – sequence: 6 givenname: Padideh surname: Asgari fullname: Asgari, Padideh organization: West Health Institute, San Diego, California, United States of America – sequence: 7 givenname: Ian surname: Pierce fullname: Pierce, Ian organization: West Health Institute, San Diego, California, United States of America – sequence: 8 givenname: Gregory surname: Norman fullname: Norman, Gregory organization: West Health Institute, San Diego, California, United States of America – sequence: 9 givenname: Eliah surname: Aronoff-Spencer fullname: Aronoff-Spencer, Eliah organization: University of California San Diego, San Diego, California, United States of America |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32407370$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_ijerph19127251 crossref_primary_10_1186_s12903_023_03285_4 crossref_primary_10_3390_ijerph18126669 crossref_primary_10_1177_00914150221106098 crossref_primary_10_4103_jiaphd_jiaphd_213_20 crossref_primary_10_1177_08959374231200840 |
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| DOI | 10.1371/journal.pone.0232898 |
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| Editor | Wilson, Fernando A. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The Gary and Mary West Health Institute (WHI - https://www.westhealth.org/what-we-do/research/) employed staff (PA, MO, IP, GN) and paid consultants (TF, EAS) to conduct this research. Apple Tree Dental (ATD - https://www.appletreedental.org/) also provided support for this study in form of compensation for BS, MH, and BP. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials. |
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| References | C Yarbrough (pone.0232898.ref006) 2016 WHO Expert Committee on Recent Advances in Oral Health & World Health Organization (pone.0232898.ref025) 1992 K Becerra (pone.0232898.ref032) 2019; 47 pone.0232898.ref038 J Weintraub (pone.0232898.ref037) 2018; 19 F Catalanotto (pone.0232898.ref043) 2017; 38 Minnesota Department of Health (pone.0232898.ref020) 2016 D Niesten (pone.0232898.ref031) 2013; 13 BJ Smith (pone.0232898.ref028) 2003 RJ Manski (pone.0232898.ref015) 2010; 70 PF Gerritsen (pone.0232898.ref034) 2011; 31 S Zimmerman (pone.0232898.ref039) 2018; 19 SO Griffin (pone.0232898.ref004) 2012; 102 RJ Manski (pone.0232898.ref011) 2017 P Crete (pone.0232898.ref041) 2018; 92 BA Dye (pone.0232898.ref002) 2015 M Freed (pone.0232898.ref005) 2019 Centers for Disease Control and Prevention (pone.0232898.ref021) 2016 A Willink (pone.0232898.ref009) 2016; 35 NJ Kassebaum (pone.0232898.ref024) 2014; 93 H Akaike (pone.0232898.ref027) 1974; 19 RJ Manski (pone.0232898.ref014) 2012; 72 W Wiebe (pone.0232898.ref026) 2000; 66 H Kiyak (pone.0232898.ref035) 1993; 21 G Gostemeyer (pone.0232898.ref019) 2019; 23 EM Ghezzi (pone.0232898.ref018) 2019; 47 M Macek (pone.0232898.ref008) 2004; 135 B Wu (pone.0232898.ref030) 2007; 97 PI Eke (pone.0232898.ref003) 2018; 149 K Nasseh (pone.0232898.ref016) 2016 A Paganini-Hill (pone.0232898.ref029) 2011; 2011 C Yarbrough (pone.0232898.ref045) 2014 BA Dye (pone.0232898.ref001) 2019; 150 C Schoen (pone.0232898.ref042) 2017 T Montini (pone.0232898.ref033) 2014; 38 United States Census Bureau (pone.0232898.ref046) 2016 Center for Health Care Strategies Inc (pone.0232898.ref012) 2018 M Helgeson (pone.0232898.ref023) 2013; 33 K Ornstein (pone.0232898.ref040) 2015; 63 RJ Manski (pone.0232898.ref013) 2016; 53 K Nasseh (pone.0232898.ref007) 2015 The Official U.S (pone.0232898.ref010) 2019 D Jacobi (pone.0232898.ref022) 2015; 43 U.S. Department of Health and Human Services (pone.0232898.ref017) 2018 pone.0232898.ref044 J Porter (pone.0232898.ref036) 2015; 13 |
| References_xml | – start-page: 44 volume-title: WHO Technical Report Series year: 1992 ident: pone.0232898.ref025 contributor: fullname: WHO Expert Committee on Recent Advances in Oral Health & World Health Organization – start-page: 197 issue: 197 year: 2015 ident: pone.0232898.ref002 article-title: Dental caries and tooth loss in adults in the United States, 2011–2012 publication-title: NCHS data brief contributor: fullname: BA Dye – volume-title: Medicaid adult dental benefits: an overview year: 2018 ident: pone.0232898.ref012 contributor: fullname: Center for Health Care Strategies Inc – volume-title: Division of Oral Health Data year: 2016 ident: pone.0232898.ref021 contributor: fullname: Centers for Disease Control and Prevention – year: 2003 ident: pone.0232898.ref028 article-title: Stability of Oral Health Status in a Long-Term Care Population: A longitudinal analysis of dental utilization [dissertation] publication-title: Ann Arbor: University of Michigan contributor: fullname: BJ Smith – year: 2016 ident: pone.0232898.ref006 article-title: Estimating the cost of introducing a Medicaid Adult dental benefit in 22 states publication-title: Health Policy Institute Research Brief contributor: fullname: C Yarbrough – volume: 2011 start-page: 156061 year: 2011 ident: pone.0232898.ref029 article-title: Dental health behaviors, dentition, and mortality in the elderly: the leisure world cohort study publication-title: J Aging Res doi: 10.4061/2011/156061 contributor: fullname: A Paganini-Hill – volume: 35 start-page: 2241 issue: 12 year: 2016 ident: pone.0232898.ref009 article-title: Dental care and Medicare beneficiaries: Access gaps, cost burdens, and policy options publication-title: Health Aff doi: 10.1377/hlthaff.2016.0829 contributor: fullname: A Willink – ident: pone.0232898.ref038 – year: 2014 ident: pone.0232898.ref045 article-title: Why adults forgo dental care: Evidence from a new national survey publication-title: Health Policy Institute contributor: fullname: C Yarbrough – volume: 92 start-page: 24 issue: 6 year: 2018 ident: pone.0232898.ref041 article-title: Access to preventive oral health services for homebound populations: A pilot program publication-title: J Dent Hyg contributor: fullname: P Crete – volume-title: Dental services: Use, expenses, source of payment, coverage and procedure type, 1996–2015. 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publication-title: Henry J Kaiser Family Foundation contributor: fullname: M Freed – volume: 150 start-page: 9 issue: 1 year: 2019 ident: pone.0232898.ref001 article-title: Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014 publication-title: J Am Dent Assoc doi: 10.1016/j.adaj.2018.09.010 contributor: fullname: BA Dye – volume: 19 start-page: 1031 issue: 12 year: 2018 ident: pone.0232898.ref039 article-title: The epidemic of poor oral hygiene publication-title: J Am Med DirAssoc contributor: fullname: S Zimmerman – ident: pone.0232898.ref044 – volume: 63 start-page: 151 issue: 1 year: 2015 ident: pone.0232898.ref040 article-title: Significant unmet oral health needs among the homebound elderly publication-title: J Am Geriatr Soc doi: 10.1111/jgs.13181 contributor: fullname: K Ornstein – volume-title: Older Adult Basic Screening Survey year: 2016 ident: pone.0232898.ref020 contributor: fullname: Minnesota Department of Health – volume: 13 start-page: 102 year: 2015 ident: pone.0232898.ref036 article-title: The impact of oral health on the quality of life of nursing home residents publication-title: Health Qual Life Outcomes doi: 10.1186/s12955-015-0300-y contributor: fullname: J Porter – volume: 47 start-page: 225 issue: 4 year: 2019 ident: pone.0232898.ref032 article-title: The Gary and Mary West Senior Dental Center: Whole-person care by community-based service integration publication-title: J Calif Dent Assoc doi: 10.1080/19424396.2019.12220775 contributor: fullname: K Becerra – volume: 53 year: 2016 ident: pone.0232898.ref013 article-title: Differences among older adults in the types of dental services used in the United States publication-title: Inquiry contributor: fullname: RJ Manski – volume: 13 start-page: 61 year: 2013 ident: pone.0232898.ref031 article-title: The impact of frailty on oral care behavior of older people: a qualitative study publication-title: BMC Oral Health doi: 10.1186/1472-6831-13-61 contributor: fullname: D Niesten – volume: 93 start-page: 20s issue: 7 Suppl year: 2014 ident: pone.0232898.ref024 article-title: Global burden of severe tooth loss: A systematic review and meta-analysis publication-title: J Dent Res doi: 10.1177/0022034514537828 contributor: fullname: NJ Kassebaum – volume-title: Race and Hispanic or Latino Origin: 2010 year: 2016 ident: pone.0232898.ref046 contributor: fullname: United States Census Bureau – volume: 33 start-page: 177 issue: 4 year: 2013 ident: pone.0232898.ref023 article-title: Oral health delivery systems for older adults and people with disabilities publication-title: Spec Care Dentist doi: 10.1111/scd.12038 contributor: fullname: M Helgeson – volume: 19 start-page: 716 issue: 6 year: 1974 ident: pone.0232898.ref027 article-title: A new look at the statistical model identification publication-title: IEEE Transactions on Automatic Control doi: 10.1109/TAC.1974.1100705 contributor: fullname: H Akaike – volume: 38 start-page: 606 issue: 9 year: 2017 ident: pone.0232898.ref043 article-title: Emerging Models of Dental Practice Aim at Addressing Needs of the Aged publication-title: Compend Contin Educ Dent contributor: fullname: F Catalanotto – volume: 19 start-page: 1086 issue: 12 year: 2018 ident: pone.0232898.ref037 article-title: Improving nursing home residents’ oral hygiene: results of a cluster randomized intervention trial publication-title: J Am Med Dir Assoc doi: 10.1016/j.jamda.2018.09.036 contributor: fullname: J Weintraub – volume: 135 start-page: 1154 issue: 8 year: 2004 ident: pone.0232898.ref008 article-title: Dental visits among older U.S. adults, 1999: the roles of dentition status and cost publication-title: J Am Dent Assoc doi: 10.14219/jada.archive.2004.0375 contributor: fullname: M Macek – volume: 149 start-page: 576 issue: 7 year: 2018 ident: pone.0232898.ref003 article-title: Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009–2014 publication-title: J Am Dent Assoc doi: 10.1016/j.adaj.2018.04.023 contributor: fullname: PI Eke – volume-title: Government Site of Medicare. Dental Services [Internet] year: 2019 ident: pone.0232898.ref010 contributor: fullname: The Official U.S – volume: 23 start-page: 979 issue: 3 year: 2019 ident: pone.0232898.ref019 article-title: Barriers and facilitators for provision of oral health care in dependent older people: a systematic review publication-title: Clin Oral Investig doi: 10.1007/s00784-019-02812-4 contributor: fullname: G Gostemeyer – volume: 38 start-page: 781 issue: 5 year: 2014 ident: pone.0232898.ref033 article-title: Barriers to dental services for older adults publication-title: Am J Health Behav doi: 10.5993/AJHB.38.5.15 contributor: fullname: T Montini – volume: 102 start-page: 411 issue: 3 year: 2012 ident: pone.0232898.ref004 article-title: Burden of oral disease among older adults and implications for public health priorities publication-title: Am J Public Health doi: 10.2105/AJPH.2011.300362 contributor: fullname: SO Griffin – volume: 70 start-page: 67 issue: 1 year: 2010 ident: pone.0232898.ref015 article-title: Dental care utilization and retirement publication-title: J Public Health Dent doi: 10.1111/j.1752-7325.2009.00145.x contributor: fullname: RJ Manski – volume: 47 start-page: 235 issue: 4 year: 2019 ident: pone.0232898.ref018 article-title: Strategies for oral health care practitioners to manage older adults through care-setting transitions publication-title: J Calif Dent Assoc doi: 10.1080/19424396.2019.12220776 contributor: fullname: EM Ghezzi – volume: 97 start-page: 2216 issue: 12 year: 2007 ident: pone.0232898.ref030 article-title: Cognitive Function and Dental Care Utilization Among Community-Dwelling Older Adults publication-title: Am J Public Health doi: 10.2105/AJPH.2007.109934 contributor: fullname: B Wu – start-page: 18 volume-title: A profile of older Americans 2017 year: 2018 ident: pone.0232898.ref017 contributor: fullname: U.S. Department of Health and Human Services – volume: 72 start-page: 179 issue: 3 year: 2012 ident: pone.0232898.ref014 article-title: Wealth effect and dental care utilization in the United States publication-title: J Public Health Dent doi: 10.1111/j.1752-7325.2012.00312.x contributor: fullname: RJ Manski |
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| Snippet | Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.
Retrospective... Background Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.... Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Retrospective... BACKGROUNDDental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been... BACKGROUND:Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.... Background Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined.... |
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| SubjectTerms | Adult Adults Age Aged Aged, 80 and over Ambulatory care Analysis Biology and Life Sciences Care and treatment Comprehensive Dental Care - economics Comprehensive Dental Care - statistics & numerical data Cost analysis Costs Demographic aspects Dental care Dental Care for Aged - economics Dental Care for Aged - statistics & numerical data Dental care services Dentition Economic aspects Elderly patients Engineering and Technology Fruit trees Government programs Health aspects Health care costs Health care policy Humans Insurance Insurance coverage Long term health care Long-term care Long-Term Care - standards Longitudinal Studies Male Medicaid Medical care utilization Medicine and Health Sciences Middle Aged Minnesota Older people Oral diseases Oral health Oral hygiene Outpatients - statistics & numerical data People and Places Preventive medicine Retrospective Studies Setting (Literature) Social aspects Teeth Time Tooth loss Utilization |
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| Title | Longitudinal analysis of cost and dental utilization patterns for older adults in outpatient and long-term care settings in Minnesota |
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