Autor: |
Waite MD; Pediatric Dentist in Private Practice and at Mercy Hospital, St. Louis, Mo., USA., Sheller B; Chief of Pediatric Dentistry, Seattle Children's Hospital and an Affiliate Professor, Departments of Orthodontics and Pediatric Dentistry, University of Washington School of Dentistry, USA., Velan EK; pediatric dentists, Seattle Children's Hospital, and affiliate assistant professors, Department of Pediatric Dentistry University of Washington School of Dentistry, Seattle, Wash., USA., Reeves A; pediatric dentists, Seattle Children's Hospital, and affiliate assistant professors, Department of Pediatric Dentistry University of Washington School of Dentistry, Seattle, Wash., USA., Wang Y; Biostatistician, School of Public Health, University of California Los Angeles, Los Angeles, Calif., USA. |
Abstrakt: |
Purpose: To describe social determinants of health (SDOH) in a group of children with special health care needs (CSHCN) planned for dental procedures with general anesthesia (GA) at a pediatric hospital and explore associations between SDOH and completing this treatment in the recommended timeframe. Methods: SDOH were recorded for all patients planned for dental treatment with GA in 2019. Outcomes were treatment completed in the recommended timeframe or treatment not completed within two years of planning. Results: Dental surgery plans were made for 390 CSHCN: 190 were completed in the recommended timeframe, and 119 were not completed within two years. The SDOH associated with completing/not completing surgery were parents (guardian/caregiver)/household, and documentation of social work involvement with the family. Patients receiving optimally timed surgery more frequently had two parents/one household and/or an active social work plan on the record. Those not receiving surgery frequently had two parents/two households, single parents, and/or had no social work plan. Ethnicity, payer, and the need for an interpreter were not associated with receiving timely surgery. Conclusions: Multiple studies have found that social determinants of health contribute to disparate health outcomes. In this study, children with two parents in one household appear to be advantaged in receiving care in the recommended timeframe. Families with SDOH challenges who had a social work plan were frequently able to overcome SDOH barriers and receive dental treatment with general anesthesia in the timeframe recommended. |