Online Program

Occupational indicators of oral wellness: Evidence from national dental insurance claims

Wednesday, November 4, 2015 : 9:30 a.m. - 9:50 a.m.

Lorena Baccaglini, DDS, MS, PhD, College of Public Health, Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE
Kimberly McFarland, DDS, MHSA, College of Dentistry, University of Nebraska Medical Center, University of Nebraska Medical Center, Lincoln, NE
Rod TerMaat, Ameritas, Lincoln, NE
Sharon Filipi, Ameritas, Lincoln, NE
Zijian Qin, MBBS, MPH, Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, NE
Background: Occupation is a social determinant of health and it is linked to education and income. Thus, we determined whether differences in occupation were linked to oral wellness using national dental insurance claims.

Methods: We analyzed claims data from a nationwide dental insurance company. We included claimants aged 14 and older with at least one dental visit over a full 12-month coverage period (2012-2013) and employed in companies with at least 100 employees and with at least 30 employees with a dental visit. A company-level wellness grade was calculated by averaging each employee’s grade (0-100), determined based on the number of visits and severity scores of procedures submitted for reimbursement. Companies were grouped based on Standard Industrial Classification (SIC) codes and the average wellness grades were compared across SIC groups using general linear models in SAS.

Results:The overall average wellness grade of the 1,239 eligible insured companies across 48 US states was 60.0, with company-level grades ranging from 18.5 to 80.1. Overall, there were significant differences by SIC (p<0.0001). Companies classified as Education or Professional Services had the highest average grades (64.0 and 63.4, respectively), whereas companies classified as Transport/Warehouse had the lowest grade (50.8).

Conclusions: Oral wellness differed considerably by occupation. Preventive efforts should take occupation into account when selecting target populations. A study strength was the large sample size and national coverage. However, the analyses only included employed individuals who submitted a claim during the study period. Thus, results may not be generalizable to other groups.

Learning Areas:

Clinical medicine applied in public health
Public health or related research

Learning Objectives:
Compare oral wellness by occupation using dental insurance claims.

Keyword(s): Oral Health, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate professor at the College of Public Health, University of Nebraska Medical Center. I am experienced in the analysis of large data sets, including claims, EHR and national databases. I am trained as a quantitative epidemiologist with a minor in biostatistics. I have been a PI of NIH grants on analyses of national surveys.
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.