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Biomedical subjects

P Milgrom

Publications and source records attributed to P Milgrom.

At least 109 records · Page 6Linked to original sources

Utilization of dental services in the United States and an insured population.

Dental service utilization rates among 1.2 million Pennsylvania Blue Shield dental insureds are compared to rates in the US population. Insurance appears to stimulate the utilization of dental services above national norms; children appear to be a major beneficiary of insurance's incentive effect on dental service use. The implications of these findings for health planners and dental insurance providers are discussed.

Adolescent↗

Quality assurance and the role of self-evaluation and continuing education.

Optimal practice competency requires planned change. Self-evaluation, goal-setting, planning and implementing change, and continual evaluation are required to keep a practice at its best. In this article, the authors recommend steps toward regular self-assessment and new sources of information and advice.

Clinical Competence↗

Insurance plan effects on dental provider treatment patterns for elderly patients. An experimental economics approach.

Three hundred forty-six dentists, randomly selected from the population of Washington State Dental Association members, volunteered to participate in a controlled experiment of treatment planning for elderly patients. Experimental oral health problems were designed that conform to the prevailing actual distribution of dental and related systemic disease among the elderly population of the United States. Each volunteer dentist constructed two treatment plans for the presenting dental problem: 1) a treatment plan to optimize oral health, ignoring the hypothetical patient's financial status and insurance coverage; and 2) a treatment plan given the particular dental insurance plan and patient financial status incorporated in the case. Results suggest that increasingly comprehensive insurance coverage does not necessarily lead to uniform, monotonic increases in total dental expenditures. Rather, the incremental substitution of different services for one another appears to be the dominant effect of increased coverage, with the singular exception of coverage for fixed prosthodontia . The key implication of these findings is that careful design of improved insurance benefit plans for the elderly could widen the range of dental services provided without necessarily increasing total treatment cost.

Aged↗

Epidemiologic study of dental emergencies among utilizers in an insured population in Washington, USA.

This is a study of the epidemiology of dental emergencies based on information abstracted from the microfilmed dental claim forms of a large American insurance program in 1981-82. Overall, about 4% of all dental visits were classifiable as emergencies. There were significant seasonal and age variations in dental emergencies. There was no variation with respect to geographic regions in the State of Washington (USA) or sex. Paradoxically, residents in regions having fluoridated water supplies were at equal risk of developing dental emergencies due to dental caries, relative to those residing in non-fluoridated regions. There was also no difference in risk associated with insurance deductibles, although generally deductibles are thought to deter first-contact visits.

Adolescent↗

Chemotherapy and periodontal disease--a review.

Periodontal diseases are common, inflammatory infections of the mouth of microbiological etiology. Therapy traditionally focuses on professional tooth cleaning and debridement. Recent research has investigated the efficacy of antibiotic therapy, as well as the use of various other agents. Although protocols still are being developed, pharmacists can expect increasing use of these medications by dentists in the future.

Adult↗

The union of dental behavioral and clinical science: educational and research prospectives.

It has been argued that behavioral scientists too wedded to their disciplines are merely interlopers in dentistry. According to this argument, these individuals see dentistry as a laboratory for investigation but care little for the problems faced by clinicians. No doubt this has been true in some cases. However, since the growth of the discipline of behavioral medicine in the 1970s, a substantial number of behavioral scientists have been attracted to the basic problems of clinical science. These individuals have neither been seeking the role of part-time questionnaire designer, programmer, or statistician, nor are they simply seeking a laboratory for their studies. Academicians involved in behavioral medicine are genuinely interested in clinical phenomena in the healing sciences. The collaboration of behavioral scientists and clinical dental investigators has much to offer. The isolated clinician collecting data without methodological rigor is unlikely to make a major contribution. Behavioral scientists can add, beyond technical expertise, to the methodology or logic of the investigator. Moreover, the behavioral scientist and clinician may produce an enhanced understanding of behavioral factors important in clinical practice. This model for research also has implications for teaching and service. Courses integrating behavioral and clinical science can be offered based on the results of the collaborative research. Clinics employing both professional groups can use this knowledge to treat dental fear, TMJ disorders, and other problems effectively. Careful recruitment and training of behavioral scientists with research skills is needed.

Behavioral Sciences↗

The effects of continuing education in dental practice management.

A representative sample of 122 Washington State general dental practices received continuing education in the efficient utilization of auxiliaries. Dentist and staff attended a two-day workshop where goals for change in delegation to auxiliaries, scheduling, and communication were developed. The continuing dental education was individualized, required the practice to set explicit goals for change, involved both the dentist and staff in the decision-making process, and included in-office follow-up and consulting. Evaluation of the course's effects demonstrated that such a course in practice management can have a positive effect on delegation to auxiliaries, practice output, and dentist income. Degree of participation varied considerably across the 113 practices that completed the continuing education. The positive results of the training were dependent upon the practice implementing the goals for organizational change that it had set. The effects of the continuing education take time to become apparent and are sequential with changes in delegation to auxiliaries occurring first and increases in volume of services and income occurring later.

Consumer Behavior↗

Approach-avoidance conflicts regarding participation in professional activity studies.

The intrapersonal conflict hypothesis was used to explain participation and nonparticipation by health professionals in a demonstration program in quality assurance and continuing education. Two variables, "perceived benefits" and "social barriers," predict participation (p less than .024, less than .005, respectively). A discriminant analysis suggests that "benefits" has a greater impact than "barriers." The model has practical value in enhancing participation in important professional activities.

Attitude of Health Personnel↗

Evidence of the validity of a model of determinants of quality of restorative dental care.

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.

Adult↗

The probable effects of Federal Trade Commission actions on dentistry and dental education.

For the last several years the Federal Trade Commission has been actively involved in investigation and legal action within the market for dental services. The essence of FTC policy has been to promote competitive market forces in the dental care sector. This intervention has produced and will continue to produce several direct and indirect effects on dental education. By shaping the rules of the game for the dental services market and by influencing the income prospects for dental practice, the FTC's forays will alter the type of training and knowledge demanded by dental school applicants, the quality of the applicant pool, the mix of practice settings selected by newly graduated practitioners, the nature of school-based clinical practice, and the process and content of the dental school curriculum.

Advertising↗

Dentists' attitudes toward and knowledge of the elderly.

A representative sample of 332 Washington State dentists in private practice was surveyed regarding their practices, the nature and extent of their contact with elderly patients, and their attitudes toward the aged. Results show that the dentists sampled have generally inaccurate perceptions of facts on aging. More experienced dentists, and those who had greater numbers of self-paying patients, held fewer stereotypes. Dentists who rated their elderly patients as having good oral hygiene held positive stereotypes. Course work in geriatric dentistry did not discriminate between dentists with more or less incorrect perceptions. This paper also discusses implications for dental practice and training in geriatric dentistry.

Adult↗