Skip to main content
NCBI home page
Health Services Research logoLink to Health Services Research
. 1996 Feb;30(6):809–825.

Determinants of dental user groups among an elderly, low-income population.

R A Kuthy 1, M S Strayer 1, R J Caswell 1
PMCID: PMC1070094  PMID: 8591931

Abstract

OBJECTIVE: We test whether or not there are differences for selected variables among five dental user groups and one nondental group within an elderly, low-income population. DATA SOURCE: We used ten years of Medicare Part B claims data from the Cincinnati Health Department for all clinic users 62 years of age and older who participated in the Municipal Health Services Program. STUDY DESIGN: A polychotomous logistic regression model determined the ability to differentiate between the groups for each of the selected variables, controlling for race. Next, a polychotomous stepwise logistic regression was used in finding a multivariate model for determining dental user group membership. Logistic regression was used to ascertain which variables were discriminators between any two types of dental users. PRINCIPAL FINDINGS: Mean number of medical visits, mean number of prescriptions filled, and race are determinants of group membership, with the nondental group having more medical visits and more likely to be white. Although year of birth cohort is statistically significant in determining dental user types, the direction of effect is not constant across the comparisons. However, the relative risk for being in the two complete denture groups, compared to both compliant subgroups, increases with each older cohort. CONCLUSIONS: Higher levels of medical use may "crowd out" dental use, even when it is without user cost, either because the medical problems are treated as a higher priority, or because dealing with medical needs leaves too little perceived time or energy to seek dental care. Even in a low-income population seeking dental care, there appears to be a birth cohort effect with a decline in the younger elderly who require two complete dentures.

Full text

PDF
809

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atchison K. A., Mayer-Oakes S. A., Schweitzer S. O., Lubben J. E., De Jong F. J., Matthias R. E. The relationship between dental utilization and preventive participation among a well-elderly sample. J Public Health Dent. 1993 Spring;53(2):88–95. doi: 10.1111/j.1752-7325.1993.tb02681.x. [DOI] [PubMed] [Google Scholar]
  2. Brown L. J., Meskin L. H. Sociodemographic differences in tooth loss patterns in U.S. employed adults and seniors, 1985-86. Gerodontics. 1988 Dec;4(6):345–362. [PubMed] [Google Scholar]
  3. Eklund S. A., Burt B. A. Risk factors for total tooth loss in the United States; longitudinal analysis of national data. J Public Health Dent. 1994 Winter;54(1):5–14. doi: 10.1111/j.1752-7325.1994.tb01173.x. [DOI] [PubMed] [Google Scholar]
  4. Evashwick C., Conrad D., Lee F. Factors related to utilization of dental services by the elderly. Am J Public Health. 1982 Oct;72(10):1129–1135. doi: 10.2105/ajph.72.10.1129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Evashwick C., Rowe G., Diehr P., Branch L. Factors explaining the use of health care services by the elderly. Health Serv Res. 1984 Aug;19(3):357–382. [PMC free article] [PubMed] [Google Scholar]
  6. Fleming G. V., Andersen R. M. The Municipal Health Services Program. Improving access to primary care without increasing expenditures. Med Care. 1986 Jul;24(7):565–579. [PubMed] [Google Scholar]
  7. Fleming G. V., Lyttle C. S., Andersen R. M., Champney T. F., Hausner T. Impact of municipal health services Medicare waiver program. Health Care Financ Rev. 1987 Spring;8(3):13–25. [PMC free article] [PubMed] [Google Scholar]
  8. Gift H. C., Newman J. F. How older adults use oral health care services: results of a National Health Interview Survey. J Am Dent Assoc. 1993 Jan;124(1):89–93. doi: 10.14219/jada.archive.1993.0015. [DOI] [PubMed] [Google Scholar]
  9. Gilbert G. H., Branch L. G., Orav E. J. Predictors of older adults' longitudinal dental care use. Ten-year results. Med Care. 1990 Dec;28(12):1165–1180. doi: 10.1097/00005650-199012000-00005. [DOI] [PubMed] [Google Scholar]
  10. Holtzman J. M., Berkey A. B., Mann J. Predicting utilization of dental services by the aged. J Public Health Dent. 1990 Spring;50(3):164–171. doi: 10.1111/j.1752-7325.1990.tb02110.x. [DOI] [PubMed] [Google Scholar]
  11. Jones J. A., Fedele D. J., Bolden A. J., Bloom B. Gains in dental care use not shared by minority elders. J Public Health Dent. 1994 Winter;54(1):39–46. doi: 10.1111/j.1752-7325.1994.tb01177.x. [DOI] [PubMed] [Google Scholar]
  12. Kiyak H. A. An explanatory model of older persons' use of dental services. Implications for health policy. Med Care. 1987 Oct;25(10):936–952. doi: 10.1097/00005650-198710000-00003. [DOI] [PubMed] [Google Scholar]
  13. Wolinsky F. D., Arnold C. L. A birth cohort analysis of dental contact among elderly Americans. Am J Public Health. 1989 Jan;79(1):47–51. doi: 10.2105/ajph.79.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES