Utilization of preventive oral health care by Medicaid-enrolled senior adults during their transition from community-dwelling to nursing facility residence

Abstract

for enduring through this process with me. Drs. Warren and Levy for instilling a supportive environment among all the graduate students. Daisy and all the other DPH graduate students for support and friendship! Abstract OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities. METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission. RESULTS: During the 5-year study 52.8% of the subjects never received a dental exam and 75.9% never received a hygiene procedure. Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p<0.001). Subjects residing in a facility located in an urban area (p<0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure. CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.