Evaluating Oral Health Services in RWPB Clinics, Georgia DPH, 2015-2016

Abstract

This cross-sectional study assessed dental care utilization by people living with HIV/AIDS (PLWHA) who received services at Ryan White Part B Primary Care Clinics in Georgia between April 2015 and March 2016. Overall, only about 20% of PLWHA received dental care within the past year, with large geographic variation. We identified common barriers to obtaining routine preventive dental care, including transportation, health literacy, and funding. We compared data from this study, CAREWare, and manual chart audits for consistency.

Proposal Summary

Background: Routine chart and CAREWare audits indicate that people living with HIV/AIDS (PLWHA) in Georgia do not receive routine dental care, but the specific obstacles that prevent clients from receiving these services has not been evaluated. This study assessed dental care utilization among PLWHA who receive services at Ryan White Part B (RWPB) Primary Care Clinics in Georgia and identified the barriers that prevent them from accessing care. Methods: Of the 19 Georgia Department of Health (GA-DPH) districts, HIV coordinators from all 16 districts that receive RWPB funding completed a web-based dental care needs assessment survey in October 2016, evaluating April 2015 to March 2016 (FY16). We compared findings to metrics obtained from two other sources: CAREWare, a national HIV electronic health system; and manual chart audits, performed using a weighted analysis of a random sample of clients in each district. We analyzed the survey data and compared the three instruments descriptively. Results: Of the 9,461 total active clients with HIV in the 16 DPH districts evaluated in the survey, 20% received dental care during FY16. All 16 districts had established relationships with dental providers. The average waiting period to see a dentist was <4 weeks in 13 (81%) of districts. Coordinators most frequently identified lack of transportation, health literacy, and high cost as important barriers to care. Though the overall percent of clients receiving dental services during FY16 was similar between the survey, CAREWare, and audit data, the three instruments demonstrated notable variability within sites. Proportion of clients with dental visits across Georgia showed regional variation, with fewer visits reported centrally and more dental visits reported in the northeastern and southeastern areas. Conclusion: Even though all DPH districts had access to dental providers with short waiting periods, PLWHA served by RWPB received limited dental services and faced many barriers to care during FY16. Three measurement tools demonstrated poor consistency between and across districts, highlighting the challenges in reporting and evaluating data in this population. In the coming year, GA-DPH will develop state-wide and district-specific quality improvement initiatives to improve annual dental visit rates, reduce barriers to care, and more accurately measure specific health outcomes for PLWHA.

Relevance And Significance

This proposal relates closely to two conference tracks: Access, Retention, and Care in Rural Communities; and Dental Health and HIV. Georgia Department of Public Health serves patients living with HIV/AIDS across the state. Access to dental care is of particular concern for patients in rural areas, particularly for people with complex medical issues such as HIV/AIDS. This proposal compares access to dental care by district, which reflects geographic regions. Also, this proposal looks specifically at dental care access among people living with HIV/AIDS served by Ryan White Part B, which falls within the purview of the Dental Health and HIV track.

Session Format

Poster Session

Keywords

Dental care, HIV, Ryan White Part B, CAREWare

Publication Type and Release Option

Event

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Evaluating Oral Health Services in RWPB Clinics, Georgia DPH, 2015-2016

This cross-sectional study assessed dental care utilization by people living with HIV/AIDS (PLWHA) who received services at Ryan White Part B Primary Care Clinics in Georgia between April 2015 and March 2016. Overall, only about 20% of PLWHA received dental care within the past year, with large geographic variation. We identified common barriers to obtaining routine preventive dental care, including transportation, health literacy, and funding. We compared data from this study, CAREWare, and manual chart audits for consistency.