The authors examined trends in the utilization of oral health services in the United States from 1997 to 2010, including breakdowns by age and poverty level. They examined trends in one major driver of utilization: insurance coverage. The results suggest that the recent economic downturn did not result in an overall decrease in the utilization of dental services. Rather, the indings suggest an earlier decline from 2003 to 2008. In this article, the authors report that the overall trend masked signiicant variation by age and poverty level. Among children, there was steady growth in utilization from 1997 to 2010. This appears to have coincided with a shift away from private insurance toward public coverage and a signiicant drop in the percentage of uninsured children. Among non-elderly adults, however, utilization has been falling steadily since 1997 among all but the wealthiest income group. During the great recession from December 2007 to June 2009, the decline in utilization accelerated among those in the lowest income group. The decrease in adult utilization appears related to a decrease in private insurance coverage and an increase in public coverage and noninsured rates. As a consequence of these trends in coverage, the authors predict a continued decline in the utilization of dental services among non-elderly adults.Mr.
Objective
To decompose the change in pediatric and adult dental care utilization over the last decade.
Data
2001 through 2010 Medical Expenditure Panel Survey.
Study Design
The Blinder‐Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year‐specific logistic regression models. Outputs from these models were used to compute the Blinder‐Oaxaca decomposition.
Principal Findings
Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p < .05). Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization (−0.018, p < .01). Among children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences.
Conclusions
Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care.
ObjectiveTo measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children.Data2007 and 2011–2012 National Survey of Children’s Health.Study DesignDifference-in-differences and triple differences models were used to measure the impact of reforms.Principal FindingsRelative to Medicaid-ineligible children and all children from a group of control states, preventive dental care utilization increased among Medicaid-eligible children in Connecticut and Texas. Unmet dental need declined among Medicaid-eligible children in Texas.ConclusionsIncreasing Medicaid dental fees closer to private insurance fee levels has a significant impact on dental care utilization and unmet dental need among Medicaid-eligible children.
Objective: To examine the impact of the Affordable Care Act on dental care use among low-income adults ages 21-64. Methods: Our analysis uses national survey data from the
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