Provision of Care to the Underserved Populations by National Health Service Corps Alumni Dentists
ABSTRACT This study examined factors associated with dentists continuing to provide care to the underserved populations beyond their National Health Service Corps (NHSC) obligation period.
Self-administered questionnaires were mailed in 1998 to 404 dentists who had completed their service obligation between 1980 and 1997. The outcome variable was dentist self-report of continuing to work with the underserved population past NHSC obligation.
Among 249 respondents (62% response rate), 46 percent of alumni dentists continued to work with an underserved population. Multivariate analyses found that being an African American (odds ratio [OR] = 3.2), higher final salary during the NHSC assignment (OR = 1.2), and higher altruistic motivation to work with the underserved populations prior to entering NHSC (OR = 1.1) were significantly associated with continued service to the underserved populations.
A small number of factors were associated with alumni NHSC dentists' decisions to continue to provide care for the underserved populations. Targeting African-American students and students interested in caring for the underserved may improve the long-term commitment of dentists to provide care for the underserved populations. Attention will also need to be given to increased salary as a potential intervention to increase the numbers of dentists who continue to serve the underserved populations.
SourceAvailable from: yimg.com[Show abstract] [Hide abstract]
ABSTRACT: Objective: The dental safety net includes the facilities, providers, and payment programs that support dental care for underserved populations including those individuals disadvantaged by a variety of social, economic, and health conditions. Its components-health centers, dental schools, clinics, Medicaid-oriented dental practices, free-care programs, hospital emergency rooms, and others-vary in availability, comprehensiveness, continuity, and quality. The objective of this overview is to identify options and opportunities for policy changes to enhance oral health professional workforce in the safety net.Methods: Characteristics of the dental safety net and its components are reviewed and compared.Results: Professionals who now staff the dental safety net are a small subset of US dental providers and few current trainees anticipate practicing in these programs. Therefore, the safety net will continue to confront workforce challenges.Conclusions: Multifactorial policy alternatives to increase the availability of dental professionals who care of the underserved include proposed changes in dental education, licensure, scope of practice for allied dental personnel, and federal and state financing of public insurance. Also needed are local efforts to establish social norms and activities among private dentists that engage more private practitioners in care of the underserved.Journal of Public Health Dentistry 05/2010; 70(s1):S32 - S39. DOI:10.1111/j.1752-7325.2010.00176.x · 1.64 Impact Factor