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Biomedical subjects

H L Bailit

Publications and source records attributed to H L Bailit.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1982

Optimizing the dental delivery system.

This paper examines the application of information and principles derived from social science research to increasing the effectiveness and efficiency of the dental care delivery system. Four major delivery system attributes are considered: the availability, accessibility, appropriateness and acceptability of care. The dentist to population ratio is a major determinant of the availability of dental care and many factors have to be considered in deciding on the appropriate number of dentists needed in a population. Optimum size of dental practices is another aspect of availability. The evidence suggests that practices with 2 or 3 dentists are more efficient than solo practices. However, large group practices appear only to be of equal or even less efficiency than small group practices. The accessibility of dental care is influenced by the geographical location of practices, the convenience of obtaining care during non-working hours, the reduction and dissemination of information on dental fees and, most importantly, the beliefs of people concerning their oral health status. The appropriateness of care concerns the impact of different services on improving oral health. Relatively little clinical research has been published on the costs and benefits of different dental services. The acceptability of dental care concerns both patients who visit the dentist and the larger society. Studies show that patients who visit the dentist are generally satisfied with the care they receive. Societal attitudes about the dental care system have not received much attention. Although social science research on the dental care delivery system is at an early stage of development, some data exist which are relevant to optimizing the practice of dentistry.

Consumer Behavior↗
PubMed1981

A differential environmental effect on human anterior tooth size.

Factor-analytic studies of human tooth size routinely exhibit separate factors for the mesiodistal and buccolingual dimensions of anterior teeth but a single factor each for premolar and molar size. This observed independence within the anterior field is shown to be attributable to a much larger effect of environmental factors on the buccolingual vs. the mesiodistal diameters, a significant cause of which may be calculus accumulation hitherto unrecognized in the relevant literature. The heritability of dental dimensions is also discussed.

Dental Calculus↗
PubMed1981

The development of dental practice profiles.

This study examines the amount and sources of variation in dental practice profiles. Three years of insurance claims data on 227 general dental practices were used to generate practice-specific utilization rates for 16 treatment service categories. The results indicated considerable heterogeneity among and within practices in the distribution of service utilization rates such that most distributions could not be described by conventional parametric probability models. Basic standardization methods were used to examine sources of variation among practices. Of the patient and insurance characteristics investigated, only patient age had a major effect on utilization rates. However, there was considerable stability in utilization rates within practices over four consecutive six-month time intervals. The implications of these findings for profile-based utilization review and quality-assurance systems are discussed.

Adolescent↗
PubMed1980

Complex segregation analysis of Carabelli's trait in a Melanesian population.

A complex segregation analysis was performed on Carabelli's trait on the upper first molar utilizing 358 nuclear families from the Solomon Islands of Bougainville and Malaita. Simultaneous estimation of three sources of variation by the method of maximum likelihood demonstrates a significant effect of shared sibling environment which accounts for over 19% of the variance in liability for the trait. In addition, a statistically significant major gene influence is discussed and suggestions for quantifying individual liability levels for this and other dental traits are outlined.

Black People↗
PubMed1980

The metaconule: a morphologic and familial analysis of a molar cusp in humans.

Incidence and size variability of the metaconule, an accessory maxillary molar cusp, is analyzed in a series of 1,217 living Melanesians. The range of morphologic variation is quantified on a six-grade ordinal scale developed to standardize observations. Total incidence of the metaconule decreases along a mesial-to-distal gradient, while mean size and size variability increase from M1 to M3. So, while the trait is less common on distal molars, it is on average larger. Estimation of the additive genetic component is 65% for the first molar but only 15% for the second. Trait incidence and heritability estimates are generally higher for females indicating the need for separate analysis by sex.

Female↗