title: A Dental Hygiene Professional Practice Index (DHPPI) and access to oral health status and service use in the United States.
abstract: OBJECTIVE
  The purpose of this article is to summarize a larger study that developed a statistical index that defines the professional practice environment of dental hygienists (DHs) in the United States, and to determine the extent to which the index scores are related to the number of DHs and dentists, the utilization of dental services, and selected oral health outcomes across the 50 states.
  
  
  METHODS
  A Dental Hygiene Professional Practice Index (DHPPI) defines the professional status, supervision requirements, tasks permitted, and reimbursement options for DHs in each of the 50 states and the District of Columbia, as of December 31, 2001. Spearman rank order correlations between the DHPPI and numbers of oral health professionals, utilization of oral health services, and oral health outcomes in the 50 states are also presented.
  
  
  RESULTS
  The analyses revealed that: There are significant differences in the legal practice environments (as reflected in the DHPPI) across the 50 states and the District of Columbia. Between 1990 and 2001, the number of DHs per capita increased by 46% in the United States, while the number of dentists per 100,000 population increased by only 10%. The DHPPI was not significantly correlated with the number of DHs or dentists in the 50 states in 2001. The DHPPI was significantly positively correlated with the salaries of DHs in 2001. The DHPPI was also significantly and positively correlated with a number of indicators of utilization of oral health services and oral health outcomes.
  
  
  CONCLUSIONS
  Both access to oral health services and oral health outcomes are positively correlated with the DHPPI. This suggests that states with low DHPPI scores would be logical candidates for revised DH practice statutes and regulations to accomplish these objectives.
authors.affiliation: Center for Health Workforce Studies, School of Public Health, State University of New York, Albany, USA. pow01@health.state.ny.us
authors.forename: Paul
authors.initials: P
authors.lastname: Wing
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Langelier
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Continelli
authors.forename: Ann
authors.initials: A
authors.lastname: Battrell
mesh_terms: D003752:Dental Health Services / Q000706:statistics & numerical data*; D003756:Dental Hygienists / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000600:supply & distribution; D003815:Dentists / Q000600:supply & distribution; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D009909:Oral Health; D017009:Professional Autonomy; D011364:Professional Practice / Q000331:legislation & jurisprudence; D012456:Salaries and Fringe Benefits; D014481:United States