Oral Health Care in CSHCN: State Medicaid Policy Considerations

Kenney, Mary Kay

doi:10.1542/peds.2009-1255i

Cited by 24 publications

(10 citation statements)

References 21 publications

(20 reference statements)

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“…Evaluations of a single‐county project and a statewide project indicate the program is successful at increasing use of dental services including preventive dental care 35,36 . These results are consistent with analyses of national data on CSHCN, of all ages, that show variation in State Medicaid reimbursement fees was associated with children's receipt of preventive dental services even after controlling for individual and family‐level characteristics typically associated with lower utilization rates (e.g., child's age, functional limitations, household size, and receipt of needed preventive medical care) 37 …”

Section: Discussionsupporting

confidence: 80%

Parents’ perspectives on a dental home for children with special health care needs

Kagihara

Huebner

Mouradian

et al. 2011

Special Care in Dentistry

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The authors surveyed parent-leaders about aspects of a dental home for children with special health care needs (CSHCN). State leaders in two advocacy groups completed the survey; the response rate was 70.6% of all states. Two of the most highly rated aspects of a dental home, endorsed as "essential" by 89% of respondents, pertained to dentist-parent interactions: the dentist listens carefully to the family, and the dentist helps the family feel like a partner in treatment decisions. Likewise, 89% said it was essential that insurance coverage allows the child to see needed providers. Dentists' lack of knowledge or willingness to treat CSHCN and refusal of Medicaid insurance coverage were identified as major barriers to care. More than 84% of respondents reported that parents were unaware of the recommendation to establish dental care by 1 year of age. Establishing policy and educational strategies should help parents meet this dental health goal.

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Section: Discussionsupporting

confidence: 80%

Parents’ perspectives on a dental home for children with special health care needs

Kagihara

Huebner

Mouradian

et al. 2011

Special Care in Dentistry

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“…This finding may reflect the significant shortage of dentists providing preventive oral health services to young children 25 as well as the fact that incorporating preventive oral health care in the medical home, although recommended, is not yet a common practice for most physicians. [25][26][27]35 Although the medical home may play a significant role in assuring that children receive appropriate referral and follow-up for dental problems, it does not seem to be influential in assuring receipt of recommended preventive oral health care. Parents may be unaware of professional guidelines for preventive oral health care and thus may neither seek nor expect these services from the medical home.…”

Section: Discussionmentioning

confidence: 99%

“…Dental care is included because existing policy guidelines and experts promote the integration of oral health services in the medical home. [21][22][23][24][25][26][27] …”

mentioning

confidence: 99%

The Medical Home: Health Care Access and Impact for Children and Youth in the United States

et al. 2011

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OBJECTIVE: The medical home concept encompasses the elements of pediatric care considered essential for all children. We describe here the characteristics of children with medical homes and the relationship between presence of a medical home and selected health care outcomes by using new data from the 2007 National Survey of Children's Health (NSCH). METHODS: We used a medical home measure comprising 5 components: having a usual source of care; having a personal physician or nurse; receiving all needed referrals for specialty care; receiving help as needed in coordinating health and health-related care; and receiving family-centered care. A total of 83 448 children aged 1 to 17 years had valid data for all applicable medical home components. The NSCH is a random-digit-dial population-based telephone survey. RESULTS: In 2007, 56.9% of US children aged 1 to 17 years received care in medical homes. Younger children were more likely to have a medical home than their older counterparts. Substantial racial/ethnic, socioeconomic, and health-related disparities were present. Children who received care in medical homes were less likely to have unmet medical and dental needs and were more likely to have annual preventive medical visits. CONCLUSIONS: Approximately half of the children in the United States have access to all components of a pediatric medical home. Because the medical home is increasingly promoted as the standard for provision of high-quality comprehensive health care, these findings reinforce the need to continue and expand federal, state, and community efforts to ensure that all children have access to this model of care.

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“…(4–7) Almost half (48.8%) of families of CMC report ≥1 unmet health care need, and 5.4% report ≥5 unmet needs. (8) The high level of unmet needs occurs across all races/ethnicities, incomes, or insurance types of the child.…”

mentioning

confidence: 99%

Health Services and Health Care Needs Fulfilled by Structured Clinical Programs for Children with Medical Complexity

Kuo

Berry

Glader

et al. 2016

The Journal of Pediatrics

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Objective To describe family-reported health service needs of children with medical complexity, and to assess which needs are more often addressed in a tertiary care center-based structured clinical program for children with medical complexity. Study design Mailed survey to families of children with medical complexity enrolled in a structured-care program providing care coordination and oversight at one of three children’s hospitals. Outcomes included receipt of 14 specific health service needs. Paired t-tests compared unmet health care needs prior to and following program enrollment. Results 441 of 968 (46%) surveys were returned and analyzed. Respondents reported their children had a mean age of 7 (standard deviation 5) years. A majority of respondents reported the child had developmental delay (79%) and feeding difficulties (64%). Of respondents, 56% regarded the primary care provider as the primary point of contact for medical issues. Respondents reported an increase in meeting all fourteen health services needs after enrollment in a tertiary care center-based structured clinical program, including primary care checkups (82% v 96%), therapies (78% v 91%), mental health care (34% v 58%), respite care (56% v 75%), and referrals (51% v 83%) (all p<.001). Conclusions Tertiary care center-based structured clinical care programs for children with medical complexity may address and fulfill a broad range of health service needs that are not met in the primary care setting.

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Oral Health Care in CSHCN: State Medicaid Policy Considerations

Cited by 24 publications

References 21 publications

Parents’ perspectives on a dental home for children with special health care needs

Parents’ perspectives on a dental home for children with special health care needs

The Medical Home: Health Care Access and Impact for Children and Youth in the United States

Health Services and Health Care Needs Fulfilled by Structured Clinical Programs for Children with Medical Complexity

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