TY - JOUR
T1 - Dental insurance and dental care among working-age adults
T2 - differences by type and complexity of disability
AU - Horner-Johnson, Willi
AU - Dobbertin, Konrad
N1 - Publisher Copyright:
© 2016 American Association of Public Health Dentistry
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Objectives: People with disabilities experience barriers to dental care, which may vary depending on type of disability and disability complexity (e.g., impact on activities of daily living). The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. Methods: We conducted cross-sectional analysis of 2002–2011 data from the Medical Expenditure Panel Survey. Multivariable logistic regression analyses compared adults ages 18–64 in five disability type groups (physical, cognitive, vision, hearing, or multiple disabilities) to those with no disabilities, and compared people with complex activity limitations to those without complex limitations. Results: All disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. All disability groups except those with cognitive disabilities had increased odds of receiving dental checkups less than once a year. Similarly, all disability groups were at increased risk of both delayed and unmet needs for dental care. Odds ratios were generally highest for people with multiple types of disabilities. Conclusions: There are significant disparities in having dental insurance and receiving dental care for adults with disabilities, especially those with multiple types of disabilities, after controlling for socioeconomic and demographic differences. Further, disparities in care were apparent even when controlling for presence of dental insurance.
AB - Objectives: People with disabilities experience barriers to dental care, which may vary depending on type of disability and disability complexity (e.g., impact on activities of daily living). The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. Methods: We conducted cross-sectional analysis of 2002–2011 data from the Medical Expenditure Panel Survey. Multivariable logistic regression analyses compared adults ages 18–64 in five disability type groups (physical, cognitive, vision, hearing, or multiple disabilities) to those with no disabilities, and compared people with complex activity limitations to those without complex limitations. Results: All disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. All disability groups except those with cognitive disabilities had increased odds of receiving dental checkups less than once a year. Similarly, all disability groups were at increased risk of both delayed and unmet needs for dental care. Odds ratios were generally highest for people with multiple types of disabilities. Conclusions: There are significant disparities in having dental insurance and receiving dental care for adults with disabilities, especially those with multiple types of disabilities, after controlling for socioeconomic and demographic differences. Further, disparities in care were apparent even when controlling for presence of dental insurance.
KW - dental care
KW - dental insurance
KW - healthcare disparities
KW - people with disabilities
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U2 - 10.1111/jphd.12160
DO - 10.1111/jphd.12160
M3 - Article
C2 - 27265883
AN - SCOPUS:84973446584
SN - 0022-4006
VL - 76
SP - 330
EP - 339
JO - Journal of public health dentistry
JF - Journal of public health dentistry
IS - 4
ER -