The integration of medical and dental care in the dental setting offers a unique opportunity
to close medical care gaps, such as providing immunizations and laboratory-based tests,
compared with traditional nonintegrated settings.
We used a matched cohort study design among patients 65 years or older (n = 2,578)
with an index dental visit to the Kaiser Permanente Northwest medical-dental integration
(MDI) program from June 1, 2018, through December 31, 2019. MDI patients were matched
1:1 to non-MDI controls (n = 2,578) on 14 characteristics. The Kaiser Permanente Northwest
MDI program focuses on closing 23 preventive (for example, flu vaccines) and disease
management care gaps (for example, glycated hemoglobin testing) within the dental
setting. The closure of all care gaps (yes versus no) was the outcome for the analysis.
Multivariable logistic regression was used to evaluate the association between exposure
to the MDI program and level of office integration (least, moderate, and most integration)
with closure of care gaps. All data were obtained through Kaiser Permanente Northwest’s
electronic health record.
MDI patients had significantly higher odds (odds ratio [OR], 1.46, 95% confidence
interval [CI], 1.29 to 1.65) of closing all medical care gaps than non-MDI patients.
Greater MDI integration was associated with significantly higher odds of gap closure
compared with non-MDI (least integration: OR, 1.18, 95% CI, 1.02 to 1.37; moderate
integration: OR, 1.70, 95% CI, 1.36 to 2.12; most integration: OR, 2.08, 95% CI, 1.73
Patients receiving dental care in an MDI program had higher odds of closing medical
care gaps compared with similar patients receiving dental care in a non-MDI program.
MDI is effective at facilitating delivery of preventive and disease management medical