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Biomedical subjects

H L Bailit

Publications and source records attributed to H L Bailit.

At least 19 recordsLinked to original sources
PubMed1988

A principal components analysis of human odontometrics.

It has long been recognized that tooth crown diameters in hominoids are all positively intercorrelated one with another. This study reports on sex-specific correlation matrices derived from 2,650 individuals from the Solomon Islands, Melanesia. Mesiodistal and buccolingual diameters of all permanent teeth from one side are used, excluding third molars. Analysis discloses significant sex dimorphism in the strengths of the intercorrelations, with females being better integrated. Principal components analysis (PCA) provides an objective means of data reduction (shown here to be preferable to simple size summation methods) and decorrelation of the resulting linear combinations. Four components are extracted (with results being virtually identical in the two sexes) and arguments are put forth that varimax rotation to "a simpler solution" may be counterproductive. Before rotation, the four components are 1) overall size, 2) buccolingual widths contrasted with mesiodistal lengths, 3) anterior (I,C) contrasted with posterior (P,M) teeth, and 4) premolars contrasted with molars. Most of the explained (shared) variance (63%) extracted by PCA is in overall size of the dentition. There is a strong urge to view the results of these principal components analyses as reflective of biologically and genetically meaningful entities.

Female↗
PubMed1988

Changing patterns of oral health and implications for oral health manpower. Responsibility to the public.

This paper examines organized dentistry's responsibility for informing the public about changing patterns of oral disease. The public is divided into two groups: governments and other organizations that are responsible for allocating funds for dental treatment, education and research, and the general population that is eligible to use dental services. Some governments in industrialized countries apparently believe that with the decline in caries, monies for dentistry can be reduced without affecting the oral health of the population. This assumption can be challenged, since oral disease levels in lower socioeconomic class groups and the elderly continue to be very high. Further, the goals of the dental care system should be raised to eliminate edentulousness. Dentistry needs to make the public aware that adequate care for the poor and elderly and eliminating edentulousness will require increased support for dentistry. At the patient level, regular users of care who are healthy should be informed that more frequent visits and complex services may have little effect on oral health. In contrast, infrequent users of dental care should be made aware that dentistry has the technology to prevent disease and the loss of teeth. One phase in the history of dentistry is coming to an end but another is beginning. In the new era the dental profession can make even greater contributions to the quality of life of individuals and society.

Delivery of Health Care↗
PubMed1986

Dental insurance and the oral health of preschool children.

Using data from the Rand Health Insurance Experiment, the effects of cost-sharing plans on the health of the primary teeth in 264 children aged 3 to 5 years were investigated. From six areas in the United States, families were assigned at random to different dental and medical insurance plans. The plans varied in the amount of required cost sharing. Families participated in the study for 3 (70%) or 5 (30%) years. Children covered by the plan (requiring no cost sharing) had significantly fewer decayed teeth and deft (decayed, extracted, and filled teeth) at the end of the study than did children covered by the cost-sharing plans. No differences existed among plans in the number of extracted and restored teeth. Children of middle- and low-income families benefited most from having access to free dental care.

Child Health Services↗
PubMed1985

The demand for dental care: evidence from a randomized trial in health insurance.

Using data from a randomized trial in health insurance, this paper examines the effect of cost sharing on use of dental services. The data come from a sample of the nonaged, noninstitutionalized civilian population of six urban and rural sites. We find that: reducing the level of cost sharing increases demand for dental services; and dental expenses rise 46% when the coinsurance rate falls from 95% to 0%, subject to a catastrophic limit on out-of-pocket expenses. Of this increase, two-thirds is attributable to an increase in the likelihood of visiting a dentist during the year. Moreover, there is a substantial surge in demand during the first year of more generous coverage. The first-year response to cost sharing is nearly twice the second-year response.

Adolescent↗
PubMed1985

Quality assurance and development of criteria and standards.

This article considers some fundamental considerations in developing criteria and standards for use in a formal quality assurance program. These include the purpose of the review system, the types of problems being addressed, the availability of data, and the time and money that can be devoted to improving clinical performance.

Consumer Behavior↗
PubMed1983

Evaluation of a focused dental utilization review system.

It has been suggested that the efficiency of claim-based utilization review systems could be improved by focusing on providers with very high utilization rates. This strategy assumes that 1) high utilizers are more likely to be overutilizers, 2) labeling claims (e.g., "high utilizer") do not bias the review, and 3) the claim review process is sufficiently reliable. These issues were studied in prospective dental utilization review system where dentists submit claims and radiographs to an insurance carrier so that they may obtain treatment authorization. A sample of dentists with very high and moderate utilization rates for amalgams, crowns, and bridges were identified and their pretreatment claims containing these services (N = 553) were collected. Half the services from high and moderate utilizer practices were labeled "high utilizer," and the other half were unlabeled. Seven dental consultants from two large insurance carriers independently assessed the appropriateness of the services (approve or deny) from radiographs. The results indicate that services submitted by dentists with high utilization rates were no more likely to be denied than those with moderate rates, labeling claims did not appear to bias the reviewers, and interconsultant agreement levels for denials seldom exceeded 50 per cent. The study suggests that further development of focused review systems requires a better understanding of the association between utilization rates and overutilization and new methods for improving the reliability of reviewers.

Evaluation Studies as Topic↗
PubMed1982

Effects of fluoride and regular dental care on personal dental expenditures of young adults in Finland.

This paper analyzes the relationship among presence of fluoride in the drinking water, oral health and dental expenditures in four towns in Finland. A two-stage least-squares model is used to determine the effect of fluoridated water and other independent variables on the number of missing teeth and per capita annual dental service expenditures for 555 adults. The results show that regularity of dental visits is the only significant factor explaining per capita expenditures. In contrast, many factors affect the number of missing teeth; most importantly, the number of dentists per capita, level of fluoride, age, education, use of services and smoking habits. These findings suggest that fluoride significantly improves oral health status but does not reduce adult per capita dental expenditures.

Adult↗
PubMed1982

Traditional and emerging forms of dental practice: another view.

Rovin and Nash suggest that alternate dental delivery systems are more competitive and will eventually capture a large share of the dental market presently held by traditional practices. The potential advantages of alternate delivery systems, mainly advertising and capitation payment, have not received careful evaluation. It is therefore premature to conclude that alternate delivery systems are structurally more competitive. (Am J Public Health 1982; 72:662-664.)

Dentistry↗