Measuring quality of dental care during pregnancy

• Published in: The Journal of the American Dental Association (1939) Vol. 155; no. 2; pp. 167 - 176
• Main Authors: Herndon, Jill Boylston, Ojha, Diptee, Amundson, Craig
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-02-2024
• Subjects: access to care; Child; Child Health; Dental Care; Female; Health Services Accessibility; Humans; Insurance, Health; maternal and infant health; Medicaid; oral health; Pregnancy; quality of care; Reproducibility of Results; United States; United States; NQF; maternal and infant health; CPT; pregnancy; CMS; oral health; AK; WA; access to care; Committee; quality of care; CDT; CHIP; DQA; NC; ICD-10-CM; ID; MI; T-MSIS; Dental care
• ISSN: 0002-8177; 1943-4723
• DOI: 10.1016/j.adaj.2023.10.010

The authors aimed to develop and validate 2 Dental Quality Alliance measures of dental care access during pregnancy (Utilization of Services During Pregnancy, Oral Evaluation During Pregnancy) using claims and enrollment data and to report performance on these measures for a sample of Medicaid and Children’s Health Insurance Program beneficiaries.
The authors used Transformed Medicaid Statistical Information System enrollment and claims data for 7,767,806 people enrolled in 5 state Medicaid programs and Children’s Health Insurance Programs during 2018. The authors used split-half reliability testing to assess measure reliability. The authors calculated 95% CIs to assess statistically significant variation in performance between programs.
The intraclass correlation coefficient used to assess agreement between the split samples was 0.992 (95% CI, 0.941 to 0.999; P < .0001) for Utilization of Services During Pregnancy and 0.983 (95% CI, 0.879 to 0.998; P < .0001) for Oral Evaluation During Pregnancy. Performance scores ranged from 20% through 34% of beneficiaries receiving any dental service during pregnancy (Utilization of Services During Pregnancy) and from 14% through 23% of beneficiaries receiving a periodic or comprehensive oral evaluation during pregnancy (Oral Evaluation During Pregnancy), with statistically significant differences between programs.
The measures reliably assessed access to dental services and can distinguish performance between programs.
These measures can be used to advance population health by means of supporting national efforts to improve access to dental care during pregnancy.