Online Program

Receipt of dental care associated with increased adherence to HEDIS outcomes

Monday, November 2, 2015

David M. Mosen, PhD, MPH, Kaiser Permanente Center for Health Research, Portland, OR
Dan Pihlstrom, Permanente Dental Associates, Portland, OR
John Snyder, DMD, Dental Director and Chief Executive Officer, Permanente Dental Associates, Portland, OR
Kristal Rust, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
Objective: Regular dental may provide an opportunity to provide service linkage to recommended medical services and improve outcomes. However, the area has not been studied extensively. We examined the association of regular use of dental care with receipt of: 1) preventive screening services, 2) diabetes-mellitus [DM] disease management services and 3) DM-specific health outcomes.                                           

Study Design: Using a retrospective, cohort design, we identified 5,216 adults that received regular dental care compared to 5,216 persons that did not. The two patient groups were matched on propensity scores, followed for 3 years and retained medical and dental benefits. Both groups received >= 1 outpatient medical visits during each 12 month period. Receipt of regular dental care was defined as >=1 dental visits in each 12 month period. Outcome measures included Healthcare Effectiveness and Dataset (HEDIS) measures and were assessed by electronic medical record. Measures included: 1) three preventive measures (cervical, colorectal and breast cancer screening), 2) four disease management services (HbA1c and LDL-c testing; nephropathy and retinopathy screening), and 3) three health outcome measures (poor glycemic, LDL-c and blood pressure control). Logistic regression was used to examine the association of receipt of dental care with outcome measures.

Results: Receipt of regular dental care was associated with higher adherence for: 3 of 3 cancer screening measures, 1 of 4 disease management services (higher retinopathy screening) and 2 of 3 health outcomes (better glycemic control and blood pressure control).

Conclusions: Regular receipt of dental care was associated with improved adherence for 6 of 10 HEDIS outcomes.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Describe the association of receipt of medical care with Healthcare Effectiveness and Dataset (HEDIS) outcome measures in a integrated medical-dental health care delivery system. Describe which HEDIS metrics are most strongly associated with receipt of dental care in an integrated dental-medical health care delivery setting. Discuss quality improvement implications to further integrate linkage to key medical services in dental care setting.

Keyword(s): Quality of Care, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 15 years of experience conducting applied health services research; with nearly 10 years conducting medical-dental integration research. Among my scientific interests has been to better understand the association of receipt of dental care with medical outcomes for populations with chronic disease (e.g. diabetes).
Any relevant financial relationships? No

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.

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