Rural‐Urban Differences in Dental Service Utilization and Dental Service Procedures Received Among US Adults: Results From the 2016 Medical Expenditure Panel Survey

• Published in: The Journal of rural health 2021-06, Vol.37 (3), p.655-666
• Main Authors: Luo, Huabin, Wu, Qiang, Bell, Ronny A., Wright, Wanda, Quandt, Sara A., Basu, Rashmita, Moss, Mark E.
• Format: Article
• Language: English
• Subjects: Access; access to care; Adults; Black people; Case management; Dental insurance; dental procedures; Dental service; Dental treatment; dental use; Ethnic factors; Ethnic groups; Ethnicity; Expenditures; Health care expenditures; health disparities; Insurance; Minority & ethnic groups; Minority groups; Panel data; Polls & surveys; Preventive medicine; Race; Residence; Residential location; Rural areas; Rural communities; rural oral health; Rural urban differences; Sampling; Socioeconomic status; Telemedicine; Urban areas; Visits
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12500

Purpose To assess rural‐urban differences in dental service use and procedures and to explore the interaction effects of individual‐ and county‐level factors on having dental service use and procedures. Methods Data were from the 2016 Medical Expenditure Panel Survey (MEPS). We assessed rural‐urban differences in 3 outcome variables: number of dental visits (1, 2, or 3+ visits), preventive care procedures (Yes/No), and treatment procedures (Yes/No). The study sample included 8,199 adults ≥ 18 years of age who reported at least 1 dental visit in the past year. Sampling weights embedded in MEPS were incorporated into all the analyses. Findings A significant interaction between residential location and race/ethnicity (P = .030) suggested limited access to dental visits for minority groups, especially for blacks in the more rural areas. Adults from a more rural area were less likely to have received a preventive procedure (AOR = 0.55, 95% CI: 0.35‐0.87) than those from an urban area. Adults of racial/ethnic minority groups, with lower SES, and without dental insurance were less likely to have received a preventive procedure (all P < .01) but were more likely to have received a treatment procedure (all P < .05). Conclusions The study showed rural adults were less likely to have received preventive dental procedures than their urban counterparts. Racial/ethnic minority groups living in a more rural area had even more limited access to dental services. Innovative service delivery models that integrate telehealth and community‐based case management may contribute to addressing these gaps in rural communities.