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Biomedical subjects

R A Kuthy

Publications and source records attributed to R A Kuthy.

At least 19 recordsLinked to original sources
PubMed1999

Self-reported health status of low-income mothers.

PURPOSE: To determine the self-reported health status of low-income mothers before major health and welfare policy reform in the state of Ohio, to compare the health status of this group with the general population age-based norms, and to examine differences in health status among insurance and racial subgroups. Policy makers and others have a need for key health-status information about low-income mothers, a topic for which little empirical data currently exist. DESIGN: Descriptive using a cross-sectional survey with convenience sampling; 502 women were interviewed at intake sites in four countries in central Ohio, 1995 to 1996. METHODS: Health status was measured using the general health status index developed by J. E. Ware and colleagues (1995). Two summary measures, one indicating physical health and one indicating mental health, were used and compared with published norms. Multivariate logistic models were examined for depression and physical health status. FINDINGS: A significant level of depression in the population of low-income mothers was found as were differences in physical health scores by insurance group. People insured privately had the highest physical health scores, while those enrolled in fee-for-service Medicaid had scores indicating the poorest health. No significant difference was found between racial groups in self-reported health status. CONCLUSIONS: Self-reported mental health status is low among some low-income female populations. Physical health is worse for the Medicaid-enrolled group compared to both uninsured and privately insured groups. This poor state of health will likely diminish the success of welfare reform to improve the economic self-sufficiency of these women unless comprehensive health services are available.

Adult↗
PubMed1998

Dental utilization by low-income mothers.

OBJECTIVE: This study examines the influence of predisposing, enabling, and need variables on whether low-income mothers sought dental care during the past year. This report is a substudy of mothers and children on their self-reported health status, utilization, access, and satisfaction with health care in general. METHODS: A convenience sample of 502 mothers and youngest child younger than 6 years old was administered a face-to-face questionnaire in four Ohio counties. Information was collected at county human services offices and WIC clinics between November 1995 and July 1996. Using whether or not the mother sought dental care as the dependent variable, logistic regression models were created for the variables within the predisposing, enabling, and need characteristics separately and together. RESULTS: Fewer than one-half of the mothers sought dental care during the past year. Variables associated with the predisposing characteristic explained little about who sought care. Those mothers who have Medicaid coverage are 2.7 times more likely to have a dental visit than those without insurance. Moreover, those mothers who perceive any dental need are several times less likely to have received dental care than those who have no perceived need. CONCLUSIONS: Even among a somewhat homogeneous population of low-income women, source of payment for dental services and perceived need for dental care are discriminating variables in determining who seeks dental care.

Adolescent↗
PubMed1998

Preventive health counseling reported by uninsured women with limited access to care.

Low-income women in the childbearing years are at an increasing risk of becoming uninsured as welfare reforms are enacted and women enter minimum-wage jobs without insurance benefits. This study contrasts preventive counseling reported by low-income uninsured mothers and mothers insured through Medicaid. Low-income women attending Women, Infant, and Children (WIC) clinics and human services offices who had received health care during the previous 12 months (N = 406) were asked if they had received counseling from a health provider regarding any of seven types of preventive health behaviors. Uninsured women were less than half as likely to receive counseling on three or more preventive topics (OR = 0.42) as were mothers on Medicaid. Risk estimates were stable on bivariate analyses and logistic regression models. Findings indicate that opportunities for preventive health counseling need to be maximized for this group already experiencing compromised access to care.

Adult↗
PubMed1997

Predictors of dental use for low-income, urban elderly persons upon removal of financial barriers.

This study examines a low-income, urban elderly population of dental and medical, nondental users. A total of 1,378 medical, nondental users and 2,086 dental users were identified using longitudinal claims data (1983-1992) from a Medicare-waiver program that reimbursed for health care services at cost. Dental users were more likely to be from a younger age cohort (born after 1910, p = .0001) and were more likely to be black (63.3% vs 35.7%, P = .0001) than medical, nondental users. Medical, nondental users had more medical visits (p = .0001), higher medical and pharmacy charges (p = .0001), and more prescriptions (p = .0001) than did the dental users. These findings indicate that among this population of urban elderly, dental users were more likely to be black and have lower medical utilization than nondental users.

Aged↗
PubMed1997

Establishing maternal and child health data collection priorities for state and local oral health programs.

OBJECTIVE: This paper identifies specific data items for use by state and local agencies in a maternal and child oral health needs assessment model. METHODS: A modified Delphi approach was used to develop consensus on items for inclusion in the data set and their relative importance. Initially, 31 data items were chosen from several national sources. All state dental directors, along with other selected administrators and advisory committee members for this process, were asked to categorize each of the data items as core (essential), important but optional, or of lesser importance. Short comments about each data item were accepted, as were additions to the list of data items. Two rounds of comments were held. RESULTS: Eleven data items/types of information were selected as core items to be included in all needs assessments. All but one of these items were determined by the scores of the respondents. The advisory committee strongly recommended that at least one core item relate to the public's perception of oral health. Some differences in perceived importance of several items existed among the state dental directors, local dental directors, and the advisory committee. Twenty-one items were identified as being important, but optional, and seven were considered less than important and not included in the model data set. CONCLUSIONS: A modified Delphi approach facilitated the development of core and optional data items for a model oral health needs assessment. This model has potential for a common reporting mechanism so that states and local dental programs can share data.

Adolescent↗
PubMed1996

Determinants of dental user groups among an elderly, low-income population.

OBJECTIVE: We test whether or not there are differences for selected variables among five dental user groups and one nondental group within an elderly, low-income population. DATA SOURCE: We used ten years of Medicare Part B claims data from the Cincinnati Health Department for all clinic users 62 years of age and older who participated in the Municipal Health Services Program. STUDY DESIGN: A polychotomous logistic regression model determined the ability to differentiate between the groups for each of the selected variables, controlling for race. Next, a polychotomous stepwise logistic regression was used in finding a multivariate model for determining dental user group membership. Logistic regression was used to ascertain which variables were discriminators between any two types of dental users. PRINCIPAL FINDINGS: Mean number of medical visits, mean number of prescriptions filled, and race are determinants of group membership, with the nondental group having more medical visits and more likely to be white. Although year of birth cohort is statistically significant in determining dental user types, the direction of effect is not constant across the comparisons. However, the relative risk for being in the two complete denture groups, compared to both compliant subgroups, increases with each older cohort. CONCLUSIONS: Higher levels of medical use may "crowd out" dental use, even when it is without user cost, either because the medical problems are treated as a higher priority, or because dealing with medical needs leaves too little perceived time or energy to seek dental care. Even in a low-income population seeking dental care, there appears to be a birth cohort effect with a decline in the younger elderly who require two complete dentures.

Aged↗
PubMed1996

Characteristics of general dentists participating in home study courses.

With an increasing number of states requiring continuing dental education (CDE) for license renewal, dentists are opting for different ways of earning these credit hours beyond the traditional didactic presentation. One alternative is a home study correspondence course. Little is known about the type of dentists who participate in these home study courses. This study examines characteristics of 507 general dentists in Ohio who were required to submit information concerning their CDE courses and credit hours during the biennium, 1992-93. Twenty-five percent of the general dentists took at least one home study course, and approximately five percent of those dentists participating in any home study earned all their credit hours this way. A logistic regression model indicated that home study users are less likely to be ADA members and less likely to leave the state for any CDE. This study suggests that the current methods of home study courses may provide continuing education opportunities for dentists who otherwise might not be reached by more traditional ways of CDE.

Chi-Square Distribution↗
PubMed1993

Juvenile orthodontic treatment claims within a large dental insurer.

Despite many investigations regarding the relationship of health care insurance and the use of dental services, few studies have specifically examined coverage for orthodontic care. This preliminary investigation provides descriptive data concerning orthodontic services from one of the nation's largest health care insurance companies. Of the more than 1.3 million juvenile patients (ages 5 through 15 years) treated between 1986 and 1989, approximately 10.6% received comprehensive orthodontic therapy. Claims were also analyzed for variation across states and National Institute for Dental Research (NIDR) regions (with Alaska and Hawaii comprising region VIII) in terms of use and class of malocclusion. The largest percentage of comprehensive orthodontic cases in relation to the number of persons receiving any dental care exists in region III (Midwest) (11.6%). Analysis by state shows Washington, Delaware, and Pennsylvania as the leading orthodontic providers (14.3%, 13.5%, and 13.0%, respectively). Female patients comprised 56.5% of those with full-mouth treatment. Treatment most frequently commences at ages 12 years (23%) and 13 years (21.8%). In terms of classes of malocclusion, comprehensive treatment for Angle Class II is predominant (55.7%), followed by Class I (40.1%), and Class III (4.2%). Relative to total orthodontic use, Region VIII demonstrates the highest concentration of Class I patients (46%). Region I (New England) displays the greatest number of Class II cases (59.8%), whereas the largest number of Class III patients is found in the southeastern United States (region IV) (5.2%). Overall, the use of comprehensive orthodontic treatment is relatively constant over all regions, (except regions V, VI, and VIII, which fall below 10%), and mirrors that of overall dental services.

Adolescent↗
PubMed1993

Technique for standardization of panoramic radiographs using helium-neon laser guided positioning.

A limitation of the use of panoramic radiography in implant dentistry has been variations in patient positioning, which can produce dissimilar radiographs and is a serious problem in longitudinal investigations. Previous techniques to standardize panoramic radiographs have been cumbersome and technique sensitive. Bilateral helium-neon lasers were mounted on two-axis micrometer translation stages and projected as cross-hairs on a phantom skull. The cross-point of each pattern was superimposed on a facial soft tissue landmark on either side of the skull. Laser coordinates were recorded and an initial radiograph was produced for each of three experimental groups. Two investigators repeated radiographs for each group six times using the original settings. The radiographs were digitized and the variance calculated and compared using a video digital analysis program. Repeat radiographs were compared to the originals by superimposing each pair and measuring the variance in radiographic markers. The variance ranged from 0.1 to 2.2 mm with the experimental groups and from 2.5 to 38.7 mm with the control group. Repeated measures analysis of variance showed no statistical significance (P > 0.125) among each of the experimental groups using the laser system and a significant difference (P < 0.001) when the control group is included in the analysis. Variance for experimental groups was not significant between the examiners (P > 0.45). A laser repositioning system may have application in implant dentistry by standardizing panoramic radiographs for comparisons in long-term investigations.

Analysis of Variance↗
PubMed1992

Comparison of number and mean charge between dental sealants and one-surface restorations.

An important concern of the insurer is how sealants, if a covered benefit, will affect the premium. Important factors that may have an influence on determining the premium include the decline in caries rate coupled with the long-term cost to an insurer for sealants vs one-surface restorations. In this study of more than 1 million dentally insured children (aged 5-15), the mean charge ($) for sealants and one-surface restorations was determined, along with the frequency of these procedures, by patient age. For this group of children, 43 percent of one-surface restorations occurred between ages 12-14, whereas 32 percent of the patients received sealants at either 7 or 8 years of age. States varied substantially in the number of sealants as a percentage of the number of restorations. Only three states had more sealants placed than one-surface, posterior restorations. Three states had an annual increase in the ratio of sealant to restoration charge, while 13 states had an annual decrease. With the exclusion of a few states with a minimum number of sealants and restorations in 1988, the highest ratio of the cost of sealants to the cost of one-surface restorations was observed in New York (.60) and New Jersey (.56) and the lowest observed in Kansas and Utah (.37). The ratios for both New York and New Jersey were lower in 1988 than in the previous two years. The ratio of the number of one-surface, posterior restorations to the population served was approximately the same for each NIDR region in the contiguous United States. Alaska and Hawaii had a higher proportion.

Adolescent↗
PubMed1990

Dietary fluoride supplements for Ohio children--the role of the physician.

1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the physician or dentist should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast-feeding or consuming infant formula. 5. To determine the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Ohio Department of Health, Division of Laboratories can provide water fluoride-testing services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be compared to the Supplemental Fluoride Dosage Schedule to identify the correct supplement dose. 6. The Division of Dental Health, Ohio Department of Health can provide a list of communities that are optimally fluoridated. Please contact: Ohio Department of Health Division of Dental Health 246 N. High Street Columbus, Ohio 43266-0588 (614) 466-4180

Administration, Oral↗
PubMed1989

Eruption pattern of permanent molars: implications for school-based dental sealant programs.

Dental caries remains a prevalent, chronic disease of childhood. The preponderance of dental caries is located on the pit and fissure surfaces of teeth, an area where dental sealants are most effective in preventing this malady. In the school year 1987-88, 4,879 Ohio schoolchildren participated in an assessment of dental health. Grades chosen for this assessment included 1, 2, 3, 6, 7, 8, and 11. This study focuses on eruption of first and second permanent molars in development of a timing strategy for placement of occlusal sealants in a school-based program. An eruption score was developed for the determination of the first or second molar eruption status for each child. The data were analyzed for grade, sex, race, locale, fluoridation status, and percent of children on free or reduced-cost lunch programs. Analyses were performed on 2,215 children in grades 1-3 and 1,840 children in grades 6-8. Fifty-seven percent of first graders had all first permanent molars sufficiently erupted for sealant placement on the occlusal surface. Likewise, 23.6 percent of sixth graders had sufficient occlusal exposure on the second molar. Females showed an earlier eruption pattern than males for both first (P less than .05) and second (P less than .001) molars. Black children preceded white children only in the eruption of the second molar (P less than .001). This study provides dental public health decision makers with state-specific information on the earliest time to initiate a school-based occlusal sealant program.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Dietary fluoride supplements for Indiana's children: the role of the physician.

Fluoride supplements for Indiana children are necessary for caries reduction where communal and well water tests show deficient levels of fluoride. The role of the physician in providing optimum preventive dental care to young patients is discussed. Also, the proper dental protocol for fluoride supplements is provided.

Child↗