The Broad Objective of this project is to examine the use and correlates of patient visits to physician offices and/or hospital emergency departments (EDs) for the treatment of dental problems by low-income minority adults. Rationale: Poor and minority adults experience greater levels of dental disease and frequently face cost and other system-level barriers to accessing private dental practice. Therefore, these individuals may choose to receive care at alternative treatment sites, especially physician offices and EDs. However, since non-dentists receive little training in the management of dental problems, these sites may not be the most appropriate sites to receive treatment for individuals seeking definitive relief from dental problems.
Specific Aims are to: 1. Determine frequency at which low-income non-Hispanic White, non-Hispanic African-American, and Hispanic adults as compared to higher income individuals utilized physician offices and/or EDs for the treatment of dental problems during the prior 6-month period; 2. Determine predisposing, enabling, and need-based factors that predict the use of physician offices and/or EDs for the treatment of dental problems; 3..Determine nature of treatment received in physician offices and EDs; 4. Determine appropriateness and quality of the treatment received; and 5. Determine patient satisfaction with the treatment received: Research Design: The research team will use a combination of focus group, cognitive interview, and cost-effective telephone survey methodologies to identify, contact, and secure responses from low-income non-Hispanic White, non-Hispanic African-American, and Hispanic adults (data on higher income individuals will be collected for comparative purposes). The focus groups and cognitive interviews will facilitate the development of a culturally sensitive and relevant telephone survey instrument. Relevance: There are culturally related predisposing, enabling, and need-based factors, specific to low- income/minority populations that contribute to the decision to use physician offices and EDs for the treatment of dental problems. These factors must be understood more completely if decision makers are to develop polices and plan programs that address the unique social and cultural conditions that affect utilization of health services among low income/minority populations. These issues will grow in importance with the aging of the population, as elderly individuals, in general, are more likely to visit a physician than a dentist. ? ? ?
