Cost and Workflow Impact of a Primary Care Based Multi-Level Pediatric Oral Health Intervention.

Objectives: A recent trial demonstrated the effectiveness of a primary care-based multilevel intervention to increase dental attendance in 3- to 6-year-old Medicaid-insured children. We estimate the cost and workflow impact for real-world practices wishing to implement this intervention. Methods: In...

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Publicado en:Journal of Primary Care & Community Health Vol. 16; pp. 1 - 8
Autores principales: Rose, Johnie, Selvaraj, David, Ronis, Sarah D., Curtan, Shelley, Bales, Gloria C., Nelson, Suchitra
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 10/22/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 10/22/2025
      vid: 16
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/21501319251369991
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        atl: Cost and Workflow Impact of a Primary Care Based Multi-Level Pediatric Oral Health Intervention.
      aug:
        au:
          Rose, Johnie
          Selvaraj, David
          Ronis, Sarah D.
          Curtan, Shelley
          Bales, Gloria C.
          Nelson, Suchitra
        affil: Case Western Reserve University School of Medicine, Cleveland, OH, USA
      sug:
        subj:
          Medicaid Economics
          Insurance, Health Economics
          Primary Health Care
          Pediatric Dentistry
          Oral Health
          Private Practice Management
          Costs and Cost Analysis Evaluation
          Workflow Evaluation
          Human
          Funding Source
          Male
          Female
          Child, Preschool
          Secondary Analysis
          Inferential Statistics
          Health Care Costs
          Salaries and Fringe Benefits
          Electronic Health Records
          Implementation Science
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Objectives: A recent trial demonstrated the effectiveness of a primary care-based multilevel intervention to increase dental attendance in 3- to 6-year-old Medicaid-insured children. We estimate the cost and workflow impact for real-world practices wishing to implement this intervention. Methods: Intervention practices from the trial integrated oral health (OH) questions into their electronic medical records (EMR). Providers received theory-based training on delivering OH education and provided "prescriptions" for dental visits and a list of Medicaid-accepting dentists. EMR enhancement and training costs were estimated by applying nationally-representative, role-specific hourly labor costs to reported time spent by study participants performing each activity. Study staff timed the OH portion of 2 to 3 randomly selected encounters per provider. Results: Twenty-eight providers from 9 intervention pediatric practices participated. The percentage of Medicaid patients in these practices ranged from 22% to 86%. Practices corresponding in size to the smallest, median, and largest in the intervention group can expect first-year implementation costs of $579.79, $863.86, and $1482.15, respectively, with subsequent annual maintenance costs of $167.11, $451.18, and $1069.47. Encounter time for the intervention averaged 38 s longer than for standard care (control group). Conclusions: Implementation of this effective pediatric OH intervention appears to entail modest costs and lengthen encounters minimally.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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