Assessment of Access to Care of Adolescents With Special Care Needs in Ohio

Purpose: To use the audit study methodology to determine access for adolescents with special health care needs (ASHCN) in Ohio. Methods: An audit study of a balanced, random sample of general and pediatric dentists was conducted to assess willingness to treat simulated self-pay adolescents requiring three different levels of physical or emotional support: no support needs, minimal support such as audiovisual distraction, and significant support such as using a wheelchair for mobility. Descriptive and bivariate analyses were used. Results: Of the 221 offices successfully contacted (ratio equals 14 general dentists to one pediatric dentist), 206 completed responses to at least two scripts. For these offices, the extent of special health care needs was significantly associated with being offered an appointment (P<0.001). The simulated adolescent requiring minimal support was most successful in being offered an appointment (79.4 percent), and the simulated adolescent requiring significant support was least successful (49.7 percent). The wait time until appointment, if offered, increased significantly for the adolescent requiring significant support (P<0.001). Conclusions: Scheduling a new patient appointment for adolescents was difficult overall and more challenging as support needs for adolescents with special healthcare needs increased. Despite a willingness to pay out-of-pocket, fewer than half of ASCHN patients requiring significant support were offered a new patient appointment.