practical solutions to oral health data challenges kathryn k. peppe, rn, ms mark d. siegal, dds, mph...
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Practical Solutions to Oral Health Data
Challenges
Kathryn K. Peppe, RN, MSMark D. Siegal, DDS, MPH
Ohio Department of Health
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Challenges
•Needs Assessment•Advocating for resources •Educating decision-makers •Annual reporting for Title V
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MCH Block Grant Oral Health Performance
Measures (Ohio)third grade children with dental sealants on one or more permanent molar teeth (National Core)
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MCH Block Grant Oral Health Performance
Measures (Ohio)
third grade children with an obvious need for dental care (State Negotiated Measure)
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MCH Block Grant Oral Health Performance
Measures (Ohio)
6-9 y.o. EPSDT eligibles receiving a dental service (Health Status Indicator, developmental)
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FFY 2001 Ohio MCH Block Grant Needs Assessment•“Oral health problems and access to dental care” was:– one of the Top 10 MCH health issues
–the highest scoring health issue for children and adolescents
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•“Oral health problems and access to dental care” was:–mentioned among top health issues in surveys of local MCH programs, health commissioners, legislators and parents
–the #1 unmet health care need of Ohioans (Family Health Survey)
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Translating Data into Dollars
•Linkage between needs assessment and state negotiated performance measures (SPM)
•Linkage between core/SPMs and FFY2001 budget
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Ohio’s Oral Health Data Collection
Approach•1998-99 (Full survey)•2000-2004 (Annual screening surveys of sentinel schools)
•2004-05 (Full survey)
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ASTDD Needs Assessment/Data Collection Tools
•7-Step Model•Basic Screening Surveys
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Getting the GoodsNCEMCH (ASTDD
7-Step Model)703-524-7802703-524-9335 (fax)http://www.ncemch.org
ASTDD (Basic Screening Surveys)
http://www.astdd.org
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1999 Ohio Oral Health Needs Assessment Data
Collection (for joint report on access to dental care)
Oral health screening survey (336 schools)– grades 1-3, state and county levels
Key Informant surveys– Dentists– Safety Net Dental Care Programs– Low Income Consumers – School Nurses at high risk elementaries– Consumers (Ohio Family Health Survey, BRFSS)
Medicaid data collaboration
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Sentinel SchoolsPurposive sample of 25
cooperative schools, representative of 1998-99 sample of 336 schools.
Plan to screen 3rd graders annually, between large surveys.
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Selection Criteria for Sentinel Schools
• Unweighted percentages• “Cooperation” scores of 4 or 5• Schools with Blacks and Whites• At least two within +/-1/2 s.d.:
–FRM–Sealants–Obvious need for care
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Comparison of Sentinel Schools with
All Grade 3Variable All Grade 3 Sentinel
SchoolsRace (White) 89.4% 90.0%Uninsured 33.8% 35.5%F/RM Eligible 33.1% 33.6%Visit w/ in 12mos.
71.7% 71.5%
Obvious needfor care
25.7% 26.3%
Sealants 34.7% 32.9%
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Effort: Data Rich vs. Data Lite
1998- 99 2000
Grades 1- 3 3Schools/Days 336 25Children 21,114 1,197Screeners 12 2
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1998-99 Data “hooks” Sealants
•No disparity in sealants among 8 y.o. children
•Medicaid recipients who got sealants at school often had subsequent claims from other dentists
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1998-99 Data “hooks” Sealants
•Low income kids at schools with sealant programs were 3 times as likely to have sealants as those at schools without sealant programs
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1998-99 Data “hooks”Access
•FRM program children were twice as likely to have obvious need for dental care
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1998-99 Data “hooks”Access
•Parents of FRM program children were 4 times as likely to say they couldn’t get dental care that they wanted for their children–2/3 tried to get care
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Time