Factors influencing dentists’ willingness to treat Medicaid-enrolled adolescents
Date
2020-09-07
Authors
Chi, Donald L.
Kateeb, Elham T.
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Abstract
Objectives: To identify factors influencing dentists’ willingness to treat
Medicaid-enrolled adolescents with intellectual and developmental disabilities in
Washington state.
Data sources: Primary data were collected by a survey instrument administered
in 2017 to general and pediatric dentists who were Medicaid providers (N = 512).
Methods: We administered a 40-item survey, which included 20 hypothetical scenarios
involving a 12-year-old Medicaid-enrolled adolescent. Based on the characteristics
of the potential patient, dentists were asked to rate their willingness to
treat (1 = very likely; 5 = very unlikely). We used conjoint analytic techniques to
examine the relative importance of six adolescent- and family-level factors
(e.g., severity of intellectual and/or developmental disability [IDD], sugar intake,
toothbrushing, caregiver beliefs about fluoride, restorative needs, appointment
keeping) and state Medicaid reimbursement level (35 percent, 55 percent, 85 percent
of usual, customary, and reasonable amount). Analyses focused on data from
178 dentists with complete and varied responses to the scenarios.
Results: The mean age of participants was 53.8 ± 10.5 years and 10.7 percent
were pediatric dentists. The holdouts correlation statistics indicated excellent fit
for the conjoint model (Pearson’s R = 0.99, P < 0.0001; Kendall’s tau = 0.89,
P < 0.0001). Reimbursement level and appointment keeping were the most
important factors in dentists’ willingness to treat Medicaid-enrolled adolescents
(importance scores of 26.7 and 25.7, respectively). Restorative needs, caregiver
beliefs about fluoride, and IDD severity were the next most important (importance
scores of 15.4, 10.6, and 8.1, respectively). Sugar intake and toothbrushing
behaviors were the least important.
Conclusions: Reimbursement and appointment keeping were the most important
determinants of dentists’ willingness to treat Medicaid-enrolled adolescents
with IDD.
Description
Keywords
Medicaid , adolescent , intellectual and developmental disability , conjoint analysis
Citation
Chi DL, Kateeb ET. Factors influencing dentists’ willingness to treat Medicaid-enrolled adolescents. J Public Health Dent. 2020;1–8. https://doi.org/10. 1111/jphd.12391 Dentists’ willingness to treat adolescents in Medicaid D.L. Chi and E. Kateeb 8