2015–2016, Georgia Department of Public Health Districts, Evaluating Oral Health Services in Ryan White Part B Clinics

Abstract

Abstract Background Poor dental health adversely affects overall health, and people living with HIV/AIDS (PLWHA) have a higher prevalence of dental disease than the general population. This study evaluated dental care access and utilization among PLWHA who receive services at Ryan White Part B (RWPB) Clinics in Georgia using three different measurement instruments. 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 July 2015 to June 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 32–42 clients per 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% had at least one dental visit 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 average of clients with at least one dental visit during FY16 was similar between the survey, CAREWare, and audit data (20%, 16%, and 19%, respectively), 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. By developing targeted quality improvement initiatives, GA-DPH will use these finding to improve annual dental visit rates, reduce barriers to care, and more accurately measure specific health outcomes for PLWHA. Disclosures All authors: No reported disclosures.