Swati Garg1, Talia Rubin, John Jasek, Joyce Weinstein, Lisa Helburn, Katherine Kaye. 1. HHC Connectx and Patient Centered Medical Home Implementation, Office of Ambulatory Care Transformation, New York City Health and Hospitals Corporation, 125 Worth St., Room 410, New York, NY 10013, USA. swati.garg@nychhc.org
Abstract
BACKGROUND: Despite recommendations for children to have a dental visit by the age of 1 year, access to dental care for young children, including children enrolled in Medicaid, remains limited. The authors conducted a survey to assess the availability of dentists to see young children enrolled in Medicaid managed care (MMC) in New York City (NYC), to determine barriers to the provision of dental care to young children and, within the context of MMC, to identify strategies to facilitate the delivery of dental care to children. METHODS: The authors mailed a survey to assess the provision of dental services to young children and perceived barriers and facilitators to 2,311 general dentists (GDs) and 140 pediatric dentists (PDs) affiliated with NYC MMC. A total of 1,127 surveys (46 percent) were received. The authors analyzed the responses according to provider type, youngest aged child seen, provider's ability to see additional children and practice location. The authors compared responses by using the χ(2) test. RESULTS: Fewer than one-half (47 percent) of GDs saw children aged 0 through 2 years. Provider type, years in practice and percentage of Medicaid-insured patients were associated significantly (P < .005) with youngest age of child seen. Among respondents seeing children aged 0 through 2 years, PDs were significantly more likely to provide preventive therapy (P = .004) and restorative treatment (P < .001). Additional training and access to consulting PDs were identified by GDs as potential facilitators to seeing young children. CONCLUSION: A high proportion of NYC GDs affiliated with MMC do not see young children. PRACTICE IMPLICATIONS: Ninety-four percent of NYC MMC- affiliated dentists are GDs, but 53 percent of GD respondents did not see children aged 0 through 2 years in their practices. Improving access to dental care for young children requires changes in GDs' practices, possibly by means of additional training and access to consulting PDs.
BACKGROUND: Despite recommendations for children to have a dental visit by the age of 1 year, access to dental care for young children, including children enrolled in Medicaid, remains limited. The authors conducted a survey to assess the availability of dentists to see young children enrolled in Medicaid managed care (MMC) in New York City (NYC), to determine barriers to the provision of dental care to young children and, within the context of MMC, to identify strategies to facilitate the delivery of dental care to children. METHODS: The authors mailed a survey to assess the provision of dental services to young children and perceived barriers and facilitators to 2,311 general dentists (GDs) and 140 pediatric dentists (PDs) affiliated with NYC MMC. A total of 1,127 surveys (46 percent) were received. The authors analyzed the responses according to provider type, youngest aged child seen, provider's ability to see additional children and practice location. The authors compared responses by using the χ(2) test. RESULTS: Fewer than one-half (47 percent) of GDs saw children aged 0 through 2 years. Provider type, years in practice and percentage of Medicaid-insured patients were associated significantly (P < .005) with youngest age of child seen. Among respondents seeing children aged 0 through 2 years, PDs were significantly more likely to provide preventive therapy (P = .004) and restorative treatment (P < .001). Additional training and access to consulting PDs were identified by GDs as potential facilitators to seeing young children. CONCLUSION: A high proportion of NYC GDs affiliated with MMC do not see young children. PRACTICE IMPLICATIONS: Ninety-four percent of NYC MMC- affiliated dentists are GDs, but 53 percent of GD respondents did not see children aged 0 through 2 years in their practices. Improving access to dental care for young children requires changes in GDs' practices, possibly by means of additional training and access to consulting PDs.
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