Utilization of Dental Services Among Medicaid-Enrolled Children

Abstract

Objective:To assess what characteristics of children and their communities are associated with lower dental service use rates, to support development of strategies to target subgroups of children with lower utilization. Methods: Multivariate logistic regression was used to assess the association between enrollee and county characteristics and dental preventive and treatment service utilization. Data source:Principal Findings: There is substantial variation in service use by age. Relative to a 9-year-old, a 2-year-old is 28 percentage points less likely, and a 15-year-old is 15 percentage points less likely, to receive a preventive dental service. Children enrolled in Medicaid for only part of the year were significantly less likely to receive a preventive or a treatment service relative to children covered by Medicaid for the full year. For preventive care, children enrolled for nine months were 15 percentage points less likely to have a service. Those enrolled for six months were 30 points less likely; those enrolled for three months were 41 points less likely. Children eligible for Medicaid based on disability were 9 and 6 percentage points less likely to receive a preventive or treatment service, respectively, than their counterparts who were eligible based on income alone. Conclusions:This study identifies some subgroups of children who are particularly underserved and for whom states may need to devote more attention. Keywords

Do baby teeth really matter? Changing parental perception and increasing dental care utilization for young children

“…This five-year multi-level cluster randomized clinical trial aims to improve dental care access and reduce cavities among Medicaid-enrolled children 3 to 6 year old attending well-child visits. The rationale for this study is that 74% of Medicaid-enrolled young children received well-child visits [27] while only 24% received a preventive dental visit [28] despite anticipatory guidance for dental visits starting from age 1 [2]. Our premise is that oral health facts delivered by pediatric primary care providers where the messenger may be key to changing parental perceptions to seek dental care is likely to be persuasive, as suggested by a vaccine promotion messaging study [29].…”

The Effect of Medicaid Primary Care Provider Reimbursement on Access to Early Childhood Caries Preventive Services

“…; Azarpazhooh and Main ), it is difficult to reach preschool aged children for caries prevention. Publicly insured, preschool aged children are more likely to receive medical care than dental care (Bouchery ,b). Consequently, 44 state Medicaid programs have implemented policies to reimburse medical primary care providers (M‐PCPs), typically including physicians, physician assistants, and advanced registered nurse practitioners, to provide ECCPS.…”

Measuring quality of dental care

“…5 An analysis of the Medicaid Analytic eXtract files for 9 states published in 2013 found variations in the percentage of children receiving a preventive dental visit by age, race, ethnicity, and geographic area. 6 For sealant receipt specifically, researchers at the National Center for Health Statistics identified variations in dental sealant prevalence among children by age, race, ethnicity, and poverty level. 1…”

“…The DQA's overall approach for measurement development and testing for the Starter Set has been described elsewhere. 12 The purpose of this article is to provide the details of measure validation for 3 evidence-based, dental care quality measures of caries prevention that were included in the Starter Set: Sealants for [6][7][8][9] Year-Old Children at Elevated Caries Risk (Sealants 6-9), Sealants for [10][11][12][13][14] Year-Old Children at Elevated Caries Risk (Sealants 10-14), and Topical Fluoride for Children at Elevated Caries Risk (Topical Fluoride). These 3 measures fall within the category of process-of-care quality measures, in which a process of care is a "health care-related activity performed for, on behalf of, or by a patient."…”