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Regulations that restrict the tasks that credentialed workers are allowed to perform may affect a firm's input choices, output, and which part of the market the firm serves. Using dental practice survey data from 1989 to 2014 and a stacked difference-in-differences design, this paper examines the effects of state-level scope of practice regulations on the behavior of dental practices. Results suggest that scope of practice deregulation in regards to dental hygienists' ability to administer nitrous oxide or local anesthesia is associated with fewer dentist visits per week in the short-term, lower patient wait times, and an increased likelihood of treating lower revenue generating publicly insured patients. There is weak evidence that scope of practice deregulation alters a practice's labor inputs.

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Resumo: Esta tese integra o projeto de pesquisa e desenvolvimento tecnológico "Difusão e adoção do programa Fall Tailoring Interventions for Patient Safety (Fall TIPS): engajamento de pacientes, profissionais e liderança clínica para a prevenção de quedas em ambiente hospitalar". Está conectada à linha de Pesquisa de Gerenciamento de Serviços de Saúde e Enfermagem do Programa de Pós-Graduação em Enfermagem da Universidade Federal do Paraná e objetivou construir, de maneira colaborativa, uma tecnologia educativa em formato de Curso Massivo, Aberto e Online (MOOC) sobre o programa Fall TIPS Brasil para a prevenção de quedas hospitalares, valendo-se de recursos variados, como infográficos, vídeos, podcasts e jogos interativos, destinada à disseminação da proposta entre profissionais e estudantes da área da saúde; e verificar o aprendizado estatisticamente significativo em relação ao conhecimento dos cursistas antes e após o seu acesso. Primeiramente ocorreu o processo de construção do MOOC com colaboração multidisciplinar, envolvendo docentes, estudantes de graduação e pós-graduação, profissionais de saúde e do setor de ensino a distância da universidade participante, fase de desenvolvimento tecnológico. Após, a abordagem quase experimental não randomizada e não concorrente foi realizada com 21 estudantes do último período do curso de graduação em enfermagem de uma universidade pública, tendo sido submetidos a um questionário contendo 10 questões objetivas antes e após o acesso ao MOOC. Os dados foram analisados mediante estatística descritiva e analítica. A construção do MOOC foi iniciada em 2020, com a primeira edição lançada em outubro de 2023. As etapas observadas na sua elaboração incluíram a escolha do tema, a produção do curso, a avaliação preliminar e a divulgação. O conhecimento dos cursistas após o acesso foi significativamente (p <0,001) maior, quando comparado com os resultados antes do acesso. A média das notas antes do acesso ao curso foi 7,1 e, após, foi 8,9. As evidências encontradas demonstram o sucesso da intervenção. O desenvolvimento do MOOC de maneira colaborativa, o direcionamento dos materiais para o público-alvo respeitando suas dificuldades e potencialidades permitem aderência a proposta, contribuindo para que a intervenção possibilite a ampliação do conhecimento sobre o programa Fall TIPS Brasil. Assim, destaca-se a importância de os profissionais de saúde possuírem conhecimento para poderem promover o engajamento dos pacientes e acompanhantes em prol da prevenção de quedas, sendo o MOOC um recurso promissor para essa finalidade.

Abstract: This thesis integrates the research and technological development project "Diffusion and adoption of the Fall Tailoring Interventions for Patient Safety (Fall TIPS) program: engagement of patients, professionals, and clinical leadership for the prevention of falls in the hospital environment." It is connected to the Research Line in Health Services Management and Nursing of the Graduate Program in Nursing at the Federal University of Paraná and aimed to collaboratively construct an educational technology in the form of a Massive Open Online Course (MOOC) on the Fall TIPS Brazil program for the prevention of hospital falls, utilizing various resources such as infographics, videos, podcasts, and interactive games, intended for disseminating the proposal among healthcare professionals and students; and to verify statistically significant learning regarding the knowledge of the participants before and after accessing the course. First, the process of building the MOOC occurred through multidisciplinary collaboration, involving faculty, undergraduate and graduate students, healthcare professionals, and the university's distance education sector, in the phase of technological development. Subsequently, a quasi-experimental non-randomized and non-concurrent approach was conducted with 21 final-year nursing students from a public university, who were subjected to a questionnaire containing 10 objective questions before and after accessing the MOOC. Data were analyzed using descriptive and analytical statistics. The construction of the MOOC began in 2020, with the first edition launched in October 2023. The stages observed in its development included choosing the theme, producing the course, preliminary evaluation, and dissemination. Participants' knowledge after accessing the course was significantly higher (p <0,001) compared to the results before access. The average score before accessing the course was 7,1 and after was 8,9. The evidence found demonstrates the success of the intervention. Collaborative development of the MOOC, directing materials to the target audience while respecting their difficulties and potentialities, allows adherence to the proposal, contributing to expanding knowledge about the Fall TIPS Brazil program. Thus, the importance of healthcare professionals having knowledge to promote the engagement of patients and caregivers in fall prevention is highlighted, with the MOOC being a promising resource for this purpose.

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Objective:To explore the application effect of dyadic intervention scheme based on dyadic disease management theory and Information, Knowledge, Attitude, and Practice model in the discharge preparation of elderly stroke patients and family caregivers.Methods:The 92 pairs of elderly stroke patients and their caregivers hospitalized in the Department of Neurology in People′s Hospital of Zhengzhou University were conveniently selected. The non synchronous control method quasi experimental research was adopted. Totally 46 pairs of subjects who met the criteria for admission and discharge from May to July 2022 were set as the control group, and routine nursing was carried out; from August to October 2022, 46 pairs of subjects who met the criteria for admission and emission were set as the observation group to implement the dyadic intervention program. The scores of discharge readiness, self-efficacy and unplanned readmission rate of patients between the two groups were compared, and the scores of caregiver readiness, self-efficacy and caregiver stress between the two groups were compared.Results:Finally, 85 pairs of subjects completed the study, with 42 pairs in the control group and 43 pairs in the observation group. On discharge day, the total scores of discharge readiness and caregiver readiness in the observation group were (95.19 ± 4.47), (23.02 ± 2.20) points, respectively, which were higher than those in the control group (85.71 ± 5.31), (19.57 ± 1.65) points, with statistically significant differences ( t=8.91,8.16, both P<0.01); the self-efficacy levels of patients in the observation group at discharge and one month after discharge, as well as those of caregivers at discharge and one month after discharge were (73.86 ± 4.87), (75.91 ± 4.51), (75.67 ± 4.99), (79.21 ± 4.90) points, respectively, higher than those in the control group (71.62 ± 5.19), (73.33 ± 4.91), (73.48 ± 4.24), (75.48 ± 4.24) points, with statistically significant differences ( t values were from 2.05 to 3.75, all P<0.05); the pressure levels of caregivers in the observation group at discharge and one month after discharge were (7.51 ± 2.48), (6.28 ± 1.99) points, respectively, lower than those in the control group (8.76 ± 2.55), (7.45 ± 2.36) points, with statistically significant differences ( t=-2.29, -2.48, both P<0.05); the unplanned readmission rate of patients in the observation group one month after discharge was 7.0% (3/43), lower than the control group′s 23.8% (10/42), with statistically significant difference ( χ2=4.65, P<0.05). Conclusions:The implementation of dyadic intervention on elderly stroke patients and caregivers can make their discharge preparation process more adequate, thus reducing the caregiver′s care pressure, reducing the unplanned readmission rate of patients, and improving their health outcomes.

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To simultaneously promote health, economic, and environmental sustainability, a number of cities worldwide have established bike-sharing systems (BSS) that complement the conventional public transport systems. As the rapid spread of COVID-19 becoming a global pandemic disrupted urban mobility due to government-imposed lockdowns and the heightened fear of infection in crowded spaces, populations were increasingly less likely to use public transportation and instead shifted toward alternative transport systems, including BSS. In this study, we use probabilistic machine learning in a quasi-experimental research design to identify how the relevance of a comprehensive set of factors to predict the use of Bicing (the BSS in Barcelona) may have changed as COVID-19 unfolded. We unpack the key factors in predicting the use of Bicing, uncovering evidence of increasing bike-related built infrastructure (e.g., tactical urbanism), trip distance, and the income levels of neighborhoods as the most relevant predictors. Moreover, we find that the relevance of the factors in predicting Bicing usage has generally decreased during the global pandemic, suggesting altered societal behavior. Our study enhances the understanding of BSS and societal behavior, which can have important implications for developing resilient programs for cities to adopt sustainable practices through transport policy, infrastructure planning, and urban development.

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Compared to the fee-for-service (FFS) model, the managed care delivery system has the potential to improve health care management, increase provider accountability, and support better monitoring of health care quality. However, managed care organizations may attempt to control costs by curbing utilization among Medicaid beneficiaries or reducing reimbursement for Medicaid services. It is an empirical question whether managed care increases or decreases utilization of services. Using detailed pediatric public insurance dental claims data from 2016 through 2018, we examined whether the transition from FFS to managed care affects rates of dental care utilization. Between 2016 and 2018, Indiana, Missouri and Nebraska transitioned pediatric Medicaid beneficiaries from public dental fee-for-service programs to private managed care entities. Using an extended two-way fixed-effects estimation framework, we found that dental managed care leads to a decline in dental care utilization, especially when compared to states that maintain FFS provision of Medicaid dental services.

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OBJECTIVE: To examine the effectiveness of a web-based clinical pedagogy program on nurse preceptors' clinical teaching competency, self-efficacy, and attitudes toward web-based learning in comparison to face-to-face course. BACKGROUND: Preceptorship is a dynamic educational process that requires designing, and implementing various teaching strategies, evaluation, assessment and feedback. Web-based learning has been recognized as an effective learning approach for nursing professional development. DESIGN: A prospective quasi-experimental approach with two-group pre-test and post-test repeated measures was adopted. METHODS: The web-based clinical pedagogy program was provided to the preceptors in the experimental group, while control group received the face-to-face preceptorship course. Clinical Teaching Competence Inventory (CTCI), Preceptor Self-efficacy Assessment Instrument (PSEQ), and Attitudes toward Web-based Continuing Learning Survey (AWCLS) were used to evaluate preceptors' learning outcomes. Data were collected at three time points - before, immediately after the learning program, and after 6 months of the clinical teaching experience. RESULTS: A total of 150 nurses (75 participants/group) were recruited from a tertiary hospital in Singapore from July 2018 to June 2020. The results from the repeated measures analysis of covariance showed that there was a significant interaction effect (group x time) on the overall CTCI score after adjusting for covariate (F = 5.390, p = 0.005). However, there were no significant interaction effect (group x time) on PSEQ (F = 2.693, p = 0.070) and overall AWCLS score (F = 1.341, p = 0.264) between the two groups across the three time points. CONCLUSION: The web-based clinical pedagogy program produced outcomes comparable to the face-to-face program in terms of preceptors' clinical teaching competence and self-efficacy. The innovative and cost-effective web-based clinical pedagogy program provided professional development and the flexibility to accommodate preceptors' busy work schedules. Online learning has become increasingly popular during the COVID-19 pandemic and the web-based clinical pedagogy program was implemented when face-to-face workshop was not feasible.

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As flipped classroom has received much attention from researchers and educators, some scholars have investigated the effectiveness of this teaching mode in various English as a foreign language (EFL) settings; however, such an instruction mode has been under-investigated in the Chinese EFL context. Therefore, the current study examined a flipped course's impact on Chinese EFL learners' writing performance and anxiety utilizing a pretest-posttest non-equivalent group quasi-experimental design. First, it selected a sample of 50 Chinese EFL learners from two intact language school classes as the participants via the convenience sampling method. Then, it randomly assigned participants of these two intact classes to a control group (n = 24), taught based on the traditional method of writing instruction, and an experimental group (n = 26), instructed based on social media-supported flipped instruction. The study used two writing tasks and a writing anxiety inventory to gather the data from the participants. The descriptive and inferential statistics results showed that the experimental group-taught based on flipped writing instruction-significantly enhanced their writing performance. Moreover, they revealed that the flipped course substantially reduced participants' writing anxiety. Implications of such findings have been elaborated for EFL research and practice.

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Little research has examined the mental health risks of concurrent disasters. For example, disasters like wildfires have been shown to have a strong association with psychological symptoms-the 2020 U.S. Western wildfire season was the worst on record and occurred while the country was still navigating the COVID-19 pandemic. We implemented two quasi-experimental analyses, an interrupted time series analysis, and a difference-in-difference analysis to evaluate the impacts of wildfires and COVID-19 on mental health crisis help-seeking patterns. Both methods showed no statistical association between exposure to wildfires and the seeking of mental health support during the COVID-19 pandemic. Results highlighted that 2020 wildfires were not associated with an acute increase in crisis texts for youth in the two months after the events, likely due to an already elevated text volume in response to the COVID-19 pandemic from March 2020 throughout the fall wildfire season (Aug to Oct 2020). Future research is needed outside of the context of the pandemic to understand the effects of extreme and concurrent climatic events on adolescent mental health, and targeted interventions are required to ensure youth and adolescents are receiving adequate support during these types of crisis events.

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AIM: The study aimed to evaluate the effectiveness of the collaborative teaching of a multi- disciplinary team on the introductory online radiology session for the Master of Nursing students. BACKGROUND: The teaching method for basic radiology reading for the Master of Nursing program was delivered via a 4-hour didactic face-to-face lesson and was ineffective as evidenced by the students' feedback and evaluation. Therefore, a multi-disciplinary team consisting of nursing, medical and radiology staff developed a 4-week online radiology session to enhance knowledge, attitudes and confidence of the Master of Nursing students in interpreting basic chest radiographs, abdominal radiographs and computed tomographic brain scans. METHODS: A quasi-experimental study design using pre-test and post-test was adopted. The effectiveness of the online radiology session was evaluated on the students' knowledge, attitudes, and confidence. Forty Master of Nursing program students completed the pre-test and post-test questionnaires (response rate 74%) and responded to the open-ended questions in the post-test. IBM-SPSS was used to analyse the quantitative data and quantifying qualitative data technique was used to analyse the qualitative data. RESULTS: The participants demonstrated an improvement in knowledge and confidence mean scores of the post-test compared to pre-test. There was improved self-rated proficiency in reading and interpreting a film radiograph but no difference in the way they perceived the importance of radiological investigations vis-à-vis the physical examination and routine laboratory testing. Quantifying quantitative data technique showed that majority of participants appreciated the learning process as it could be done at their own pace and the lectures could be replayed again. However, participants hoped for improved interaction with the tutor during learning and the use of real-life cases in the scenarios. CONCLUSION: Collaborative teaching using an online radiology session shows promise over a traditional didactic method of teaching but requires further refinement in terms of participant interaction and the use of case examples.

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BACKGROUND: Childhood family income has been shown to be associated with later psychiatric disorders, substance misuse and violent crime, but the consistency, strength and causal nature of these associations remain unclear. METHODS: We conducted a nationwide cohort and co-sibling study of 650 680 individuals (426 886 siblings) born in Finland between 1986 and 1996 to re-examine these associations by accounting for unmeasured confounders shared between siblings. The participants were followed up from their 15th birthday until they either migrated, died, met criteria for the outcome of interest or reached the end of the study period (31 December 2017 or 31 December 2018 for substance misuse). The associations were adjusted for sex, birth year and birth order, and expressed as adjusted hazard ratios (aHRs). The outcomes included a diagnosis of a severe mental illness (schizophrenia-spectrum disorders or bipolar disorder), depression and anxiety. Substance misuse (e.g. medication prescription, hospitalization or death due to a substance use disorder or arrest for drug-related crime) and violent crime arrests were also examined. Stratified Cox regression models accounted for unmeasured confounders shared between differentially exposed siblings. RESULTS: For each $15 000 increase in family income at age 15 years, the risks of the outcomes were reduced by between 9% in severe mental illness (aHR = 0.91; 95% confidence interval: 0.90-0.92) and 23% in violent crime arrests (aHR = 0.77; 0.76-0.78). These associations were fully attenuated in the sibling-comparison models (aHR range: 0.99-1.00). Sensitivity analyses confirmed the latter findings. CONCLUSIONS: Associations between childhood family income and subsequent risks for psychiatric disorders, substance misuse and violent crime arrest were not consistent with a causal interpretation.

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Different studies show that mixed methodology can be effective in medical training. However, there are no conclusive studies in specialist training on advanced life support (ALS). The main objective of this research is to determine if, with mixed didactic methodology, which includes e-learning, similar results are produced to face-to-face training. The method used was quasi-experimental with a focus on efficiency and evaluation at seven months, in which 114 specialist doctors participated and where the analysis of the sociodemographic and pre-test variables points to the homogeneity of the groups. The intervention consisted of e-learning training plus face-to-face workshops versus standard. The results were the performance in knowledge and technical skills in cardiac arrest scenarios, the perceived quality, and the perception of the training. There were no significant differences in immediate or deferred performance. In the degree of satisfaction, a significant difference was obtained in favour of the face-to-face group. The perception in the training itself presented similar results. The main limitations consisted of sample volume, dropping out of the deferred tests, and not evaluating the transfer or the impact. Finally, mixed methodology including e-learning in ALS courses reduced the duration of the face-to-face sessions and allowed a similar performance.

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Clinical research in gynecologic oncology has seen a proliferation of studies that investigate the effectiveness of treatments using existing data sources such as cancer registries, electronic health records, and insurance claims. These observational studies are often feasible when randomized trial may not be, and may be more generalizable than randomized trials, because of greater diversity in the study populations. While statistical methods such as multivariable regression, matching, stratification, and weighting can adjust for the confounding in observational studies, statistical adjustment cannot control for confounders that are unmeasured in the data. Observational studies comparing the effectiveness of treatments for gynecologic malignancies are susceptible to bias from unmeasured confounding because factors like functional status, frailty and disease burden, which influence treatment selection and outcome, are often not reported in existing data sources. Like randomized trials, quasi-experimental designs attempt to account for both measured and unmeasured confounding by exploiting natural experiments arising in the real world. These methods are underutilized in gynecologic oncology research and are particularly relevant to studies that use large datasets to study the effectiveness of treatments. In this review, we consider methodological challenges that arise in the analysis of non-randomized studies, and describe how application of quasi-experimental methodology can estimate unbiased treatment effects even in the presence of unmeasured confounders.

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The cooperative methodology provides an opportunity for university students to develop interpersonal, social, and teamwork competences which can be decisive in their professional and social success. The research described here examines the influence of cooperative learning on the social skills necessary for teamwork. Furthermore, it analyses whether the continued use of this type of learning, the type of group, the basic social skills for teamwork, or the academic level of the students, influence their efficacy. To do so, we have designed a research project of a quasi-experimental kind with a pre-test, a post-test, and a control group, in which 346 university undergraduate students studying degrees in Infant and Primary Education completed self-report surveys about behavior patterns in social skills concerning self-assertion and the reception and imparting of information in teamwork situations. The results show that cooperative learning in university classrooms is effective as a method for developing the social skills necessary for teamwork, as well as the relevance of the control over the number of students in a group, the basic social skills, or the academic level of the students, as relevant factors related with efficacy; where continuity over time in the use of the cooperative methodology is what marks the greatest differences in the development of the social skills necessary for teamwork. It is important to stress that when students are asked to work autonomously in teams, with the aim of favoring the development of social skills, they should be given adequate structures that can guarantee the minimum conditions of participation, so as to allow a proper development of the said social skills.

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BACKGROUND: Studies have shown that sarcopenia easily leads to difficulty moving, disability, and poor quality of life. However, researches on the use of whole-body vibration for older adults with sarcopenia living in institutions have been lacking. Therefore, the main objective of the present study was to investigate the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of older adults with sarcopenia living in institutions. METHODS: This study adopted a quasi-experimental, single-group, pretest-posttest design. The whole-body vibration intervention was performed over a 3-month period, in which the older adults trained 3 times per week; each training lasted 60 s with a break of 30 s for 10 repetitions. The older adults' skeletal muscle mass index, physical fitness and quality of life before and after the intervention of the whole-body vibration was collected. Concerning the statistical methods adopted, nonparametric method-based tests were employed. RESULTS: According to the results of analysis, after the intervention of the 12-week whole-body vibration, the skeletal muscle mass index (z = - 3.621, p = 0.000), physical fitness on standing on one foot (z = - 2.447, p = 0.014), shoulder-arm flexibility (z = - 3.159, p = 0.002), 8-ft up and go test (z = - 2.692, p = 0.009), hand grip strength (z = - 3.388, p = 0.009), and five repeated sit-to-stand tests (z = - 2.936, p = 0.003), all improved significantly. Furthermore, concerning the quality of life of the older adults in the pretest and posttest, the improvements were statistically significant (z = - 2.533, p = 0.011). CONCLUSIONS: The study results showed the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of sarcopenic older people living in institutions and could serve as a crucial reference to health care professionals.

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BACKGROUND: Rotavirus is a highly contagious virus causing gastroenteritis, mostly in children under the age of 5. Since 2006, two vaccines are available in Germany. In 2013, these were included into the German national vaccination schedule. The aim of this intervention is to reduce the incidence and hospitalization among children under 5 years caused by rotavirus. The effectiveness of the intervention was analyzed in this study. METHODS: National surveillance data of laboratory confirmed rotavirus infections among children under the age of 5 were analyzed using interrupted time-series analysis. Weekly incidence from 2011 to 2017 and monthly hospital discharge rates from 2005 to 2015 were analyzed using a segmented generalized linear model with Poisson distribution. RESULTS: After adjusting for seasonal effects the incidence were approximately 22% (95% CI: 13.2-30.1) lower than expected following the intervention. The hospitalizations were approximately 27% (95% CI: 14.9-39.7) lower than expected following the intervention. The long-term effects of the intervention were nearly zero. The incidence changed in trend by -0.2% (95% CI: -0.1 to (-0.3)) and the hospitalizations by +0.2% (95% CI: 1.2-(-0.8)) following the intervention. CONCLUSION: After the inclusion of the vaccines into the national vaccination schedule significant immediate effects of this intervention were found. The weekly incidences and monthly hospitalization caused by the rotavirus were more than 20% lower than expected. The long-term effects of the intervention however were found to be nearly zero. This could be caused by a low vaccination rate in the German population.

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The aim of the current study was to examine the effectiveness of a school-centered multicomponent PA intervention, called 'Active Living', on children's daily PA levels. A quasi-experimental design was used including 9 intervention schools and 9 matched control schools located in the Netherlands. The baseline measurement took place between March-June 2013, and follow-up measurements were conducted 12months afterwards. Accelerometer (ActiGraph, GT3X+) data of 520 children aged 8-11years were collected and supplemented with demographics and weather conditions data. Implementation magnitude of the interventions was measured by keeping logbooks on the number of implemented physical environmental interventions (PEIs) and social environmental interventions (SEIs). Multilevel multivariate linear regression analyses were used to study changes in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) between baseline and follow-up. Finally, effect sizes (ESs) were calculated using Cohen's d. No pooled effects on PA and SB were found between children exposed and not exposed to Active Living after 12months. However, children attending Active Living schools that implemented larger numbers of both PEIs and SEIs engaged in 15 more minutes of LPA per weekday at follow-up than children in the control condition (ES=0.41; p<.05). Moreover, children attending these schools spent less time in SB at follow-up (ES=0.33), although this effect was non-significant. No significant effects were found on MVPA. A school-centered multicomponent PA intervention holds the potential to activate children, but a comprehensive set of intervention elements with a sufficient magnitude is necessary to achieve at least moderate effect sizes.

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Evaluations of red light camera (RLC) traffic safety programs have produced mixed results. Some conclude RLCs were associated with significant increases in motor vehicle crashes and injury crashes, whereas other research reports safety benefits. To understand the difference in findings, the present analysis assessed whether standards required for internal validity in quasi-experimental public health program evaluations were adhered to in frequently cited RLC analyses. Four evaluation standards were identified and used to assess the RLC analyses: lack of bias in the selection of both (a) treated sites and (b) comparison sites, (c) integration of relevant control variables in the analysis, and (d) full disclosure of results of the statistical analysis. Six leading RLC studies were then critiqued. Only two of the six studies adhered to the four standards and both concluded RLCs were associated with significant increases in crashes and injury or possible injury crashes. A third study reported an increase in fatal/injury crashes but did not test for statistical significance. Three studies reported equivocal findings; however, each failed to adhere to most standards. Differences in findings were attributed to the evaluation methods used. If implementing an RLC program, communities should use sound public health evaluation methods to assess effectiveness.

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In the United States, occupational regulations influence the work tasks that may legally be performed by dentists and dental hygienists. Only a dentist may legally perform most dental procedures; however, a smaller list of basic procedures may be provided by either a dentist or a dental hygienist. Since dentists and hygienists possess different levels of training and skill and receive very different wages, it is plausible that these regulations could distort the optimal allocation of skills to work tasks. We present simple theoretical framework that shows different ways that such regulations might affect the way that dentists and dental hygienists are used in the production of dental services. We then use a large database of dental insurance claims to study the effects of the regulations on the prevailing prices of a set of basic dental services. Our empirical analysis exploits variation across states and over time in the list of services that may be provided by either type of worker. Our main results suggest that the task-specific occupational regulations increase prices by about 12%. We also examine the effects of related occupational regulations on the utilization of basic dental services. We find that allowing insurers to directly reimburse hygienists for their work increases one year utilization rates by 3-4 percentage points.

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