Online Program

Healthcare Delivery Redesign in Action: Implementing a Public Health Dental Program to Address the Needs of Chronic Disease Patients in Bexar County, Texas

Monday, November 2, 2015

Sadaf Rafique, MS, Department of Health Analytics-Research and Information Management, University Heath System, San Antonio, TX
Anna McAndrew, Health Care Services, University Health System-Robert B. Green Campus, San Antonio, TX
Camerino I. Salazar, MS, Health Analytics, Research and Information Management, University Health System, San Antonio, TX
Violetta Roller, DDS, CommuniCare Health Centers, San Antonio, TX
Theresa De La Haya, RN, MPH, Community Health and Clinical Preventive Programs, University Health System, San Antonio, TX
Background: It is estimated that close to 108 million people in the U.S. have no dental insurance. Oral health disparities are particularly present in economically vulnerable persons of color who are less likely to have access to oral health care services. In Bexar County, Texas, Hispanics, African-Americans, and individuals living in the Southern regions of the county are less likely to rate their oral health status good-to-excellent or report having adequate dental health coverage. To address these needs, University Health System partnered with Federally Qualified Health Centers (FQHCs) to expand dental coverage for medically and economically underserved residents.

Methods: Dental chart review audits were applied to assess dental service outcomes among the patient population. Program costs, measures, and resource utilization were captured through a database built to centralize dental procedures from partner FQHC sites.   

Results:  A total of 144 patients across 855 dental care visits began treatment over the course of the first implementation year.  A group of intervention patients (n = 78) were tracked from the beginning of their treatment. Through dental chart review, 34 patients completed their treatment with 10 (29%) demonstrating improvement in periodontal disease status by the end of first implementation year.

Conclusion: Collaborating with FQHCs was critical in identifying capacity and needed resources for providing and expanding access to dental services for chronic disease patients. Through these partnerships, timely access to dental care and level of awareness regarding the importance of oral health to overall health and well-being were achieved.

Learning Areas:

Implementation of health education strategies, interventions and programs
Program planning
Public health or related public policy

Learning Objectives:
Describe the planning and implementation of a dental partnership between a major safety-net hospital and Federally Qualified Health Centers in the context of era healthcare transformation and payment reform Evaluate the reach and effectiveness of a patient navigation-based intervention to address the unique oral health needs of chronic disease populations Discuss accomplishments, challenges, lessons learned in operationalizing a public health dental program

Keyword(s): Oral Health, Special Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead evaluator for multiple grant funded projects pertaining to clinical and preventive health service. In my current capacity, I am responsible for database development, data managemnet, and project monitoring for community health improvement efforts within a major safety-net healthcare system.
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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