Protocol - Affordability Problems in Accessing Dental Care

Description

The MEPS-HC is an interview-administered questionnaire that collects information on health and health care at the household level. This protocol identifies whether each household member has a medical provider who provides the usual source of care, reasons why members without a usual source of care do not have one, aspects of satisfaction with usual care providers, and problems a household may have experienced in obtaining needed health care.

Specific Instructions

The household must first be enumerated to identify whether the household is a single-person or multi-person response unit (RU). The Working Group recommends ascertaining the relationships between the RU members rather than asking for the full names of RU members. Investigators should collect the relationship of the household member to the respondent, as described in Household Roster-Relationships (11402).

Availability

Available

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Protocol

‘MONTH YEAR-1’ = the month of the current interview and the current interview year minus 1.

[SINGLE-PERSON RU/MULTI-PERSON RU] Now please think only about dental care. In the last 12 months [that is, between {MONTH YEAR-1} and today],{have you/has {PERSON}} delayed seeking dental care (including check-ups)/has dental care (including check-ups) been delayed for anyone in the household} because of worry about the cost?

[ ] Yes
[ ] No
[ ] Refused
[ ] Don’t know

[Ask if 1 = YES and a MULTI-PERSON RU] Who was that?
PROBE: Did anyone else delay seeking dental care (including check-ups) because of worry about the cost?
ENTER ALL THAT APPLY.

Full Name 1: __________________
Full Name 2: __________________
Full Name 3: __________________
Full Name 4: __________________
Full Name 5: __________________

[Ask if 1 = NO, REFUSED, or DONT KNOW] [SINGLE-PERSON RU/MULTI-PERSON RU] In the last 12 months, was there any time when {{you/{PERSON}}/anyone in the household} needed dental care, but did not get it because {{you/he/she}/they} couldn’t afford it?

[ ] Yes
[ ] No
[ ] Refused
[ ] Don’t know

[Ask if 3 = YES and a MULTI-PERSON RU] Who was that?
PROBE: Did anyone else need dental care but did not get it because they couldn’t afford it?
ENTER ALL THAT APPLY.

Full Name 1: __________________
Full Name 2: __________________
Full Name 3: __________________
Full Name 4: __________________
Full Name 5: __________________

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a “don’t know” response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Interviewer-administered questionnaire

Lifestage

Adult

Participants

Adults aged 18 years or older

Selection Rationale

The Medical Expenditure Panel Survey Household Component (MEPS-HC) is a validated, widely used tool that assesses a household’s usual source of care and other aspects of access to health care.

Language

English, Other languages available at source

Standards

Standard	Name	ID	Source

Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Medical Expenditure Panel Survey Household Component (MEPS-HC)

Source

Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Household Component (MEPS-HC), 2020, Access to Care (AC) section, items AC250 (AC1189), AC260 (AC1190), AC270 (AC1191), AC280 (AC1192)

General References

Chen, Y., Zhang, P., Luman, E. T., Griffin, S. O., & Rolka, D. B. (2021). Incremental dental expenditures associated with diabetes among noninstitutionalized U.S. adults aged ≥18 years old in 2016-2017. Diabetes Care, 44(6), 1317-1323. https://doi.org/10.2337/dc20-2744

Cohen, S. B., & Cohen, J. W. (2013). The capacity of the Medical Expenditure Panel Survey to inform the Affordable Care Act. Inquiry, 50(2), 124-134. https://doi.org/10.1177/0046958013513678

Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N., Mauldin, P. D., & Moran, W. P. (2018). trends in healthcare expenditures among US adults with hypertension: national estimates, 2003-2014. Journal of the American Heart Association, 7(11), e008731. https://doi.org/10.1161/JAHA.118.008731

Stransky M. L. (2018). Unmet needs for care and medications, cost as a reason for unmet needs, and unmet needs as a big problem, due to health-care provider (dis)continuity. Journal of patient experience, 5(4), 258-266. https://doi.org/10.1177/2374373518755499

Wehby, G. L., Lyu, W., & Shane, D. (2022). Racial and ethnic disparities in dental services use declined after Medicaid adult dental coverage expansions. Health Affairs (Project Hope), 41(1), 44-52. https://doi.org/10.1377/hlthaff.2021.01191

Protocol ID

280701

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry
	PX280701010000	Now please think only about dental care. In more the last 12 months [that is, between {MONTH YEAR-1} and today],{have you/has {PERSON}} delayed seeking dental care (including check-ups)/has dental care (including check-ups) been delayed for anyone in the household} because of worry about the cost? show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry_Who_1
	PX280701020100	Who was that? PROBE: Did anyone else delay more seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Full Name 1 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry_Who_2
	PX280701020200	Who was that? PROBE: Did anyone else delay more seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Full Name 2 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry_Who_3
	PX280701020300	Who was that? PROBE: Did anyone else delay more seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Full Name 3 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry_Who_4
	PX280701020400	Who was that? PROBE: Did anyone else delay more seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Full Name 4 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Delay_Worry_Who_5
	PX280701020500	Who was that? PROBE: Did anyone else delay more seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Full Name 5 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford
	PX280701030000	In the last 12 months, was there any time more when {{you/{PERSON}}/anyone in the household} needed dental care, but did not get it because {{you/he/she}/they} couldn't afford it? show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford_Who_1
	PX280701040100	Who was that? PROBE: Did anyone else need more dental care but did not get it because they couldn't afford it? ENTER ALL THAT APPLY. Full Name 1 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford_Who_2
	PX280701040200	Who was that? PROBE: Did anyone else need more dental care but did not get it because they couldn't afford it? ENTER ALL THAT APPLY. Full Name 2 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford_Who_3
	PX280701040300	Who was that? PROBE: Did anyone else need more dental care but did not get it because they couldn't afford it? ENTER ALL THAT APPLY. Full Name 3 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford_Who_4
	PX280701040400	Who was that? PROBE: Did anyone else need more dental care but did not get it because they couldn't afford it? ENTER ALL THAT APPLY. Full Name 4 show less	N/A
PX280701_Affordability_Problems_Access_Dental_Care_Not_Afford_Who_5
	PX280701040500	Who was that? PROBE: Did anyone else need more dental care but did not get it because they couldn't afford it? ENTER ALL THAT APPLY. Full Name 5 show less	N/A

Individual Social Determinants of Health

Measure Name

Affordability Problems in Accessing Dental Care

Release Date

December 14, 2022

Definition

Affordability of dental care affects whether individuals and their household members have access to care.

Purpose

To assess delays in seeking dental care due to cost. Delayed access to preventive dental health care can negatively impact health.

Keywords

Access, health care, services, Medical Expenditure Panel Survey, MEPS, Agency for Healthcare Research and Quality, AHRQ, usual source of care, barriers, dental, household, medical provider, accessibility, availability, Access to Health Care

Measure Protocols

Protocol ID	Protocol Name
280701	Affordability Problems in Accessing Dental Care

Publications

Burnett-Bowie, S. A. M., et al. (2024) The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report. Journal of Bone and Mineral Research. 2024 May; 39(5): 517-530. doi: 10.1093/jbmr/zjae048

Bartholomew, T. S., et al. (2024) Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services Addiction Science & Clinical Practice. 2024 March; 19(1). doi: 10.1186/s13722-024-00447-9