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Evaluating Oral Health Service Utilization by Ryan White Part-A Beneficiaries

This capstone project aims to evaluate the low utilization of oral health services by beneficiaries of the Ryan White Part-A program in 2019. The consequences of poor dental health and the impact of HIV on oral health are considered. The project involves data collection through administrative, clinical, and support service sources. Findings indicate low oral health utilization, with barriers including income, insurance, and viral loads. Next steps involve exploring provider capacity, engaging stakeholders through focus groups and interviews, and developing effective education campaigns.

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Evaluating Oral Health Service Utilization by Ryan White Part-A Beneficiaries

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  1. TO EVALUATE THE LOW UTILIZATION OF ORAL HEALTH SERVICES BY BENEFICIARIES OF RYAN WHITE PART-A PROGRAM 2019 Capstone Project, Gurpreet Kaur, DDSMPH Epidemioloy University of Maryland Greater Baltimore HIV Heath Services Planning Council Patrick Chaulk, MD, MPH

  2. Consequences of poor dental health • Gum disease • Tooth decay • Tooth erosion • Mouth sores • Tooth sensitivity, aches and emergencies • Oral cancer • Cosmetic needs • Bad breath • Negative impact on healthy diet

  3. Consequences of HIV and oral health • Increased susceptibility to dental infections • Mouth: first body part to be affected by HIV infection • People with HIV may experience: • Dry mouth • Thrush/Candidiasis • Oral hairy leukoplakia • Red band gingivitis • Kaposi’s sarcoma • HSV-1 infections • Mouth ulcers (Pakfetrat et. al., 2015)

  4. Data collection • CAREWare, 2017 data • Nature of data collected • Administrative • Clinical • Support service data • Tabular reports completed annually by Ryan White grantees and their subcontractors

  5. Sample size • Sample size: • Inclusion criteria: patients receiving medical, non-medical or support services under Ryan White Part-A program

  6. Outcome variable

  7. Age

  8. Gender

  9. Race & Ethnicity

  10. Insurance Status

  11. Income Status

  12. Oral health visits

  13. Population CharacteristicsBased on Access to Oral Health Visits

  14. Population CharacteristicsBased on Access to Oral Health Visits

  15. Findings • Oral health utilization is low • Barriers: • Income • Insurance • Viral loads • Not retained in care • Protective factors • Age • Public insurance: Medicaid, Medicare, Ryan White

  16. Next Steps • Utilization is low, but why? • Is there a provider capacity issue? • MSA versus jurisdictions • Best practices local and national • Focus group and key informant interviews and/or surveys • Clients • Providers • Develop effective education campaign: clients and providers • Identify potential partners: • State pilot program for dual eligibles • University of Maryland Dental School • Maryland Dental Association

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