牙科保健员自主性对牙科保健利用的影响

Jie Chen, C. Meyerhoefer, E. Timmons
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引用次数: 1

摘要

由于卫生保健提供者的供应相对于卫生保健服务的需求有限,人们认为,增加卫生保健提供者的自主权可以减少提供某些服务的障碍,从而改善获得卫生保健的机会。然而,关于执业范围法对卫生和牙科专业人员的影响的研究是有限的。我们使用2001-2014年医疗支出小组调查来调查管理牙科保健师实践自主权的法规对牙科保健使用和支出的影响。我们通过将口腔卫生专业实践指数扩展到2001-2014年来衡量自治法规的强度,使我们能够捕捉各州内法规随时间的变化。使用差异中的差异框架,我们发现放松监督要求,为牙科保健员提供更大的自主权,在牙科保健提供者短缺的地区,牙科保健利用水平更高。此外,扩大牙科保健员的自主权增加了牙科保健员提供的许多服务的使用,如清洁、氟化物治疗、密封剂应用和填充物。我们还发现,更大的自主权降低了个人和第三方支付者与牙科治疗相关的成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Dental Hygienist Autonomy on Dental Care Utilization
Because of the limited supply of health care providers relative to the demand for health care services, increases in provider autonomy are believed to improve access to health care by reducing barriers to the provision of certain services. However, research on the impact of scope of practice laws for health and dental professionals is limited. We investigate the effects of regulations governing the practice autonomy of dental hygienists on dental care use and expenditure using the 2001–2014 Medical Expenditure Panel Survey. We measure the strength of autonomy regulations by extending the Dental Hygiene Professional Practice Index to the years 2001–2014, allowing us to capture changes in regulations within states over time. Using a difference-in-differences framework, we find that relaxing supervision requirements to provide dental hygienists greater autonomy results in higher levels of dental care utilization in areas with a shortage of dental care providers. Moreover, expanding dental hygienist autonomy increased the use of many services that dental hygienists perform, such as cleanings, fluoride treatments, sealant applications, and fillings. We also find that greater autonomy reduces costs associated with dental treatment for both individuals and third-party payers.
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