Practical Solutions to Oral Health Data

Challenges

Kathryn K. Peppe, RN, MSMark D. Siegal, DDS, MPH

Ohio Department of Health

Challenges

•Needs Assessment•Advocating for resources •Educating decision-makers •Annual reporting for Title V

MCH Block Grant Oral Health Performance

Measures (Ohio)third grade children with dental sealants on one or more permanent molar teeth (National Core)

MCH Block Grant Oral Health Performance

Measures (Ohio)

third grade children with an obvious need for dental care (State Negotiated Measure)

MCH Block Grant Oral Health Performance

Measures (Ohio)

6-9 y.o. EPSDT eligibles receiving a dental service (Health Status Indicator, developmental)

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

•“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)

Translating Data into Dollars

•Linkage between needs assessment and state negotiated performance measures (SPM)

•Linkage between core/SPMs and FFY2001 budget

Ohio’s Oral Health Data Collection

Approach•1998-99 (Full survey)•2000-2004 (Annual screening surveys of sentinel schools)

•2004-05 (Full survey)

ASTDD Needs Assessment/Data Collection Tools

•7-Step Model•Basic Screening Surveys

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

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

Sentinel SchoolsPurposive sample of 25

cooperative schools, representative of 1998-99 sample of 336 schools.

Plan to screen 3rd graders annually, between large surveys.

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

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%

Effort: Data Rich vs. Data Lite

1998- 99 2000

Grades 1- 3 3Schools/Days 336 25Children 21,114 1,197Screeners 12 2

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

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

1998-99 Data “hooks”Access

•FRM program children were twice as likely to have obvious need for dental care

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

Time