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Abstract #154968

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Thomas R. Konrad, PhD, Program on Health Professions and Primary Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr. Blvd., CB#7590, Chapel Hill, NC 27599-7590, 919-966-2501, konrad@schsr.unc.edu, Neel Bhatavadekar, BDS, MS, MPH, Dept. of Periodontology, University of Texas Health Science Center, 6516 M.D. Anderson Blvd, Room 310, Houston, TX 27514, and Gary Rozier, DDS, Dept. of Health Policy and Administration, Dept. of Health Policy and Administration, UNC School of Public Health, Columbia Drive, Chapel Hill, NC 27514.

Uneven distribution of dentists and their low participation the Medicaid program limits access to care in North Carolina (NC). The National Health Service Corps (NHSC) deploys dentists to underserved communities, but long-term retention is not well-documented. We sought to learn how NHSC dentists completing service obligations (19 NHSC alumni) differ from other dentists starting practice between 1990-1999 in NC (50 comparisons) and if NHSC status affects continued work with underserved populations With survey data from all NHSC alumni and 68% of comparisons, difference of means tests and regression models examined effects of dentists' NHSC status, race, motivations, and incentives on current work with underserved populations.. Compared to similar dentists, NHSC alumni were more likely to work in “safety net” settings (84% vs. 23%) and with Medicaid patients (60% vs. 19%); to .be African-American, speak Spanish, want to “provide care in an underserved area,” with distinctive clienteles (children, Hispanic patients) and service styles (more walk-ins, shorter appointments, longer waits). Despite having lower incomes than comparisons ($121K vs. $166K), NHSC alumni have similar workloads, hours, and job satisfaction. Multivariate analyses found participation in Medicaid and work in safety net settings was affected by dentists' race, altruism, financial incentives and previous NHSC participation. The NHSC is an effective federal resource complementing state policies aimed at increasing access in public and private practice settings in NC. To amplify the financial incentive of NHSC loan repayment, dental workforce planners and educators should collaborate to recruit African-Americans and other dentists wanting to work in underserved communities.

Learning Objectives:

• 1)Identify the problem of access to dental care in North Carolina
• 2)Compare National Health Service Corps alumni dentists with other dentists, and assess if NHSC service affects continued service for underserved populations beyond the NHSC service committment.

Keywords: Oral Health, Workforce

Related Web page: www.healthworkforce.unc.edu/documents/oralhealthsafetynet_abstract_100306.pdf

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Audio (mp3) recording
• Slides (pdf) or Handout
• Multimedia recording