The supply of dentists and access to care in rural Kansas.
BACKGROUND
Rural deficits in dental care and oral health are well documented and are typically attributed to the low number of dentists practicing in rural areas, but the relationships between rural residence, dental supply, and access to care have not been firmly established, impeding the development of effective public policy.


OBJECTIVE
The purpose of this study is to develop a conceptual framework for observed variations in dental supply, oral health, and access to dental care in rural versus nonrural areas, and to test key empirical implications of this framework (eg, whether lower levels of utilization are associated with the lack of dentists and/or other aspects of residence in a rural area).


METHODS
This study employs descriptive statistics, bivariate analyses, and multiple logistic regression to describe the relationship between oral health, access to care, and the supply of dentists in rural versus nonrural populations. Data analyzed includes Kansas' dental licensure records and the 2002 Behavioral Risk Factor Surveillance System.


RESULTS
Bivariate results confirm that dental supply, access to care, and oral health are lower for populations living in rural areas. Multivariate models indicate that dentist supply has a positive and independent association with utilization, but that rurality is not associated with utilization and oral health after controlling for demographics and dentist supply.


CONCLUSIONS
Findings are consistent with a conceptual framework linking the geography of rural residence, individual preferences for services such as dental care, and the financial disincentives for dentists to locate in rural areas.
Allison
R Andrew
RA
Kansas Health Policy Authority, Topeka, KS 66603, USA. Allison@khpa.ks.gov
Manski
Richard J
RJ
D003752:Dental Health Services / Q000600:supply & distribution; D003815:Dentists / Q000600:supply & distribution*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007615:Kansas; D016015:Logistic Models; D011365:Professional Practice Location; D019035:Rural Health Services / Q000600:supply & distribution; D000078329:Workforce