Dentist-reported differences in services provided to patients with public vs. private dental insurance.

INTRODUCTION: Variation in dentists' provision of types of dental services based on patients' insurance may impact population access to comprehensive care. The aim of this study was to describe differences in the types of services provided to adult patients with Medicaid versus private insurance among private practice general dentists. METHODS: The data source was a 2019 survey of private practice dentists in Iowa, and the study sample included general dentists with current or recent participation in Iowa's Medicaid program for adults (n = 264). Bivariate analyses were used to compare differences in the types of services provided to privately insured and publicly insured patients. RESULTS: Dentists reported the greatest differences in services provided to patients with public versus private insurance for prosthodontic procedures, including complete dentures, removable partial dentures, and crown and bridge services. Endodontic services were the least frequently provided category of services provided by dentists for both patient groups. Patterns were generally similar among both urban and rural providers. CONCLUSION: Access to dental care for Medicaid members should be evaluated not only on the proportion of dentists who see new Medicaid patients but also on the types of services dentists provide to this population.

Variation in dentist participation between dental medicaid managed care organizations.

OBJECTIVES: Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental Managed Care Organizations (MCOs) in states with more than one. This study examined the variation in participation overall and in predictors of dentist participation between two MCOs in Iowa's Dental Medicaid program. METHODS: Data were obtained from a survey of Iowa private practice dentists (n = 1256). Responding general dentists (n = 497) were included in the final analytic sample. Univariate, bivariate, and multivariable logistic regression analyses were conducted to examine demographic and practice characteristics associated with dentist participation (acceptance of new Medicaid patients) between MCOs and by age category. RESULTS: Among respondents, the proportions accepting new adults with Medicaid were 26% (MCO 1) and 7% (MCO 2); for children, they were 40% (MCO 1) and 11% (MCO 2). For adults, dentists who were too busy (MCO1) and solo practice dentists (MCO2) were positively significantly associated with the acceptance of new patients. For children, group and rural practice dentists, as well as dentists who worked <32 h/week were positively significantly associated with acceptance of new patients with MCO1. CONCLUSIONS: There was considerable variation in dentist-reported acceptance of new adult and child Medicaid patients, and in the factors affecting acceptance of new patients between MCOs in Iowa dental Medicaid. Future studies of Medicaid participation should consider variations by MCO in states with more than one dental MCO so as not to miss important factors affecting Medicaid participation.

Lessons from the coronavirus disease 2019 (COVID-19) pandemic response in China, Italy, and the U.S.: a guide for Africa and low- and middle-income countries.

Africa can be "left behind" after other advanced continents recover from the coronavirus disease 2019 (COVID-19) pandemic as reflected by the global pandemic of HIV/AIDS. In this paper, we summarize potentially adaptable, effective and innovative strategies from China, Italy, and the U.S. The purpose is to help African countries with weaker healthcare systems better respond to the COVID-19 pandemic. China, being the first to report COVID-19 infection swiftly swung into anti-epidemic actions by the use of innovative risk communication and epidemic containment strategies. Italy and U.S., the next rapidly hit countries after China, however, experienced sustained infections and deaths due to delayed and ineffective response. Many African countries responded poorly to the COVID-19 pandemic as evidenced by the limited capacity for public health surveillance, poor leadership, low education and socioeconomic status, among others. Experience from China, Italy and U.S. suggests that a better response to the COVID-19 pandemic in Africa needs a strong public health leadership, proactive strategies, innovative risk communication about the pandemic, massive tests and isolation, and scaling-up community engagement. Lastly, African countries must collaborate with other countries to facilitate real-time information and experience exchange with other countries to avoid being left behind.