Thesis (MSD)--Boston University, Henry M. Goldman School of Dental Medicine, 2008 (Dept. of Health Policy and Health Services Research). / Includes bibliography: leaves 44-48. / 0bjective: The objective of this study is to detemine if there are differences by race or ethnicity in dental care provided at community health center clinics resulting in oral health disparities. This study also provides detailed information about the types of dental procedures received by patients at community health center clinics.
Methods: This was a retrospective observational study design, consisting of a convenience sample of patients seen and care provided by senior dental students during their ten-week externship at twenty one Boston University Goldman School of Dental Medicine affiliated community health center clinics. The data collected was analyzed SAS version 9.1. Frequencies for categorical variables, means for continuous variable, bivariate analyses and generalized models of logistic regression analysis were performed with the main dependent variable of interest being patient’s race/ethnicity.
Results: The total sample was 62,112 observations, of which 56% were females. Regression analysis found that Blacks were 1.23 times and Asians and others were 1.09 times more likely to get diagnostic procedures than Whites. Hispanics were just as likely to receive diagnostic procedures as Whites. Blacks, Hispanics, Asians and others were more likely to get preventive procedures when compared to Whites (p[less than or equal to]0.0001 ). Blacks were less likely to get restorative procedures than Whites (p[less than or equal to]0.0001) whereas Hispanics were as likely to get restorative procedures as Whites.
Further generalized logistic regression models to predict specific procedures were performed which indicates that Blacks were 1.99 times, Hispanics were 1.72 times, Asians and others were 1.21 times more likely to get amalgam restorations compared to composite restorations than Whites. However, Blacks were as likely to get root canal therapy compared to extractions as Whites whereas Hispanics were 27% and Asians and others were 37% more likely to get root canal therapy versus extractions than Whites (p[less than or equal to]0.0001). Blacks were 0.55 times, Asians and others were 0.37 times less likely to receive fixed partial dentures compared to removable partial dentures than Whites (p[less than or equal to]0.0001) whereas Hispanics were just as likely to receive fixed Partial dentures as Whites.
Conclusion: Disparities were seen in the receipt of dental services provided such as diagnostic, preventive, and restorative procedures based on race at community health center clinics. This surprising finding related to community health center clinics indicate the need for future research focused on reasons for these disparities as community health center clinics are primary care providers for underserved populations.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/37812 |
| Date | January 2008 |
| Creators | Grover, Simran |
| Publisher | Boston University |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | This work is being made available in OpenBU by permission of its author, and is available for research purposes only. All rights are reserved to the author. |
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