Article Analyzes US Oral Health Care System's Capacity to Treat Children with Special Health Care Needs

April 22, 2011

Website Link http://www.ingentaconnect.com/content/aapd/pd/2011/00000033/00000002/art00004?crawler=true

This analysis is the first known attempt to determine the availability of care for CSHCN [children with special health care needs] from the standpoint of sheer numbers of children per capable providers," write the authors of an article published in the March-April 2011 issue of Pediatric Dentistry. Access to oral health care is a significant concern for many parents of CSHCN, and CSHCN are more likely than other children to have unmet needs for oral health care. The purposes of the study described in this article were to determine the capacity of the U.S. oral health care system to treat CSHCN and to create a national portrait of care available from known sources, using data from national sources and a recent survey of children's hospitals.

The study used available national data, making assumptions about care based on existing literature to construct a conceptual model for oral health care for CSHCN. Data came from hospitals and institutes affiliated with the National Association of Children's Hospitals and Related Institutions; additional data came from online databases, literature-based reports, and websites.

The authors found that:

The typical children's hospital dental clinic had a very limited capacity for either routine dental appointments or operating room appointments for the CSHCN attributed to its site -- less than one appointment available per child with special health care needs.
In the United States overall, the average number of CSHCN per provider (children's hospitals, hospital-based clinics, dental schools, pedodontic residencies, pediatric dentists) was 1,857, ranging from 1,327 to 2,357 depending on district in the country.
The total number of children with special health care needs (from birth through age 18) in the United States was 10,221,436.
In the country overall, there were 220 children's hospitals with the capacity to provide oral health care to CSHCN, 87 hospital-based clinics, 57 dental schools, 69 pedodontic residencies, and 5,291 pediatric dentists.
The distribution of treatment capacity resources varied from district to district, with the fewest resources in the western United States.

The authors conclude that "the results of this analysis . . . confirm the lack of capacity to care for . . . [CSHCN]."

Kerins C, Casamassimo PS, Ciesla D, et al. 2011. A preliminary analysis of the US dental health care system's capacity to treat children with special health care needs. Pediatric Dentistry 33(2):107-112. Abstract available here.