Innovative Examination of Existing Data: Indiana Oral Healthcare Workforce and Access to Care

Background: Recognizing access to oral healthcare as an important issue, the federal government created a system to designate geographic areas as having a shortage. Dental Health Professional Shortage Area (DHPSA) designations are associated with federal allocations for oral healthcare workforce development. Indiana currently has fewer DHPSA designations than surrounding states, which is due, in part, to challenges associated with the required data collection, specifically a low response rate to survey attempts. Methods: This study examines the individual and system characteristics of 2900 dentists who were surveyed during the 2010 biennial license renewal (response rate 81%, n=2701) to identify the distribution of shortage areas and develop recommendations for an enhanced data collection method. Data to support analysis came from state and federal sources. Statistical tests were performed to determine association between characteristics and survey response. Results: 36 counties non-urban Indiana Counties were identified as currently having dental health provider shortages, and further analysis demonstrated that certain individual characteristics of dentists including age, years licensed, race, providing care for small children, and Medicaid provider status were significantly associated with survey response. Conclusion: In order to increase access to oral healthcare in Indiana, DHPSA should be sought out for these areas experiencing shortages. To efficiently collect the provider data necessary for HPSA designations, legislative action to mandate a survey of dentists during the biennial license renewal process should be considered.