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Lamster IB, Malloy KP, DiMura PM, Cheng B, Wagner VL, Matson J, Proj A, Xi Y, Abel SN, Alfano MC. Dental Services and Health Outcomes in the New York State Medicaid Program. J Dent Res 2021; 100:928-934. [PMID: 33880960 PMCID: PMC8293758 DOI: 10.1177/00220345211007448] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Previous reports suggest that periodontal treatment is associated with improved health care outcomes and reduced costs. Using data from the New York State Medicaid program, rates of emergency department (ED) use and inpatient admissions (IPs), as well as costs for ED, IPs, pharmacy, and total health care, were studied to determine the association of preventive dental care to health care outcomes. Utilization of dental services in the first 2 y (July 2012-June 2014) was compared to health care outcomes in the final year (July 2014-June 2015). Costs and utilization for members who did not receive dental services (No Dental) were compared to those who received any dental care (Any Dental), any preventive dental care (PDC), PDC without an extraction and/or endodontic treatment (PDC without Ext/Endo), PDC with an Ext/Endo (PDC with Ext/Endo), or Ext/Endo without PDC (Ext/Endo without PDC). Propensity scores were used to adjust for potential confounders. After adjustment, ED rate ratios were significantly lower for PDC and PDC without Ext/Endo but higher for the Any Dental and Ext/Endo without PDC. IP ratios were lower for all treatment groups except Ext/Endo without PDC. ED costs differed little compared to the No Dental group except for Ext/Endo without PDC. For IPs, costs per member were significantly lower for all groups (-$262.91 [95% confidence interval (CI), -325.40 to -200.42] to -$379.82 [95% CI, -451.27 to -308.37]) except for Ext/Endo without PDC. For total health care costs, Ext/Endo without PDC had a significantly greater total health care cost ($530.50 [95% CI, 156.99-904.01]). Each additional PDC visit was associated with a 3% reduction in the relative risk for ED and 9% reduction for IPs. Costs also decreased for total health care (-$235.64 [95% CI, -299.95 to -171.33]) and IP (-$181.39 [95% CI, -208.73 to -154.05]). In conclusion, an association between PDC and improved health care outcomes was observed, with the opposite association for Ext/Endo without PDC.
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Affiliation(s)
- I B Lamster
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Columbia University College of Dental Medicine, New York, NY, USA
| | - K P Malloy
- Bureau of Chronic Disease Evaluation and Research, CSP Data Unit, Office of Public Health, New York State Department of Health (NYSDOH), Albany, NY, USA
| | - P M DiMura
- Bureau of Research and Analysis, Division of Performance Improvement and Patient Safety, Office of Quality and Patient Safety, NYSDOH, New York, NY, USA
| | - B Cheng
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - V L Wagner
- Bureau of Research and Analysis, Division of Performance Improvement and Patient Safety, Office of Quality and Patient Safety, NYSDOH, New York, NY, USA
| | - J Matson
- Division of Performance Improvement and Patient Safety, Office of Quality and Patient Safety, NYSDOH, Albany, NY, USA
| | - A Proj
- Bureau of Chronic Disease Evaluation and Research, CSP Data Unit, Office of Public Health, New York State Department of Health (NYSDOH), Albany, NY, USA
| | - Y Xi
- Bureau of Environmental and Occupational Epidemiology, NYSDOH, New York, NY, USA
| | - S N Abel
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - M C Alfano
- College of Dentistry, New York University, New York, NY, USA
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Jandhyala BS, Malloy KP, Buckley JP. Effects of acute administration of delta9-tetrahydrocannabinol on pulmonary hemodynamics of anesthetized dogs. Eur J Pharmacol 1976; 38:183-7. [PMID: 954827 DOI: 10.1016/0014-2999(76)90216-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
I.v. administration of delta9-THC (2.5 mg/kg) To anesthetized dogs resulted in a decrease in heart rate, pulmonary blood flow (PBF), and a significant increase in pulmonary artery pressure (PAP) and total pulmonary vascular resistance (PVR). The increase in PVR to delta9-THC was significantly reduced by cardiac pacing, and was virtually abolished either by bilateral vagotomy or by pretreatment with hexamethonium. The data indicated the delta9-THC induced elevation of PVR was mediated via reflexogenic mechanisms involving afferent vagi and efferent autonomic pathways.
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Jandhyala BS, Malloy KP, Buckley JP. Effects of chronic administration of delta9-tetrahydrocannabinol on the heart rate of mongrel dogs. Res Commun Chem Pathol Pharmacol 1976; 14:201-4. [PMID: 935652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Chronic administration of delta9-tetrahydrocannabinol (delta9-THC) 1 mg/kg, s.c. twice a day for 7 days failed to produce any significant alterations in the peripheral autonomic transmission to the heart of mongrel dogs anesthetized with sodium pentobarbital. Prior to anesthesia, heart rate of the treated dogs was slightly greater than that of the placebo group. However, under pentobarbital anesthesia, heart rate of the delta9-THC treated animals was significantly lower than that of the placebo group. The data suggested that chronic delta9-THC may have an inhibitory effect on the central vagal structures and in addition, this agent antagonizes the ability of pentobarbital to elevate heart rate in dogs.
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