S Amanda Dumas1, Deborah Polk2. 1. Division of Ambulatory Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA. 2. School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
OBJECTIVES: Examine dental utilization by Medicaid-insured children living in a high-resource area. Characterize distance and travel-related variables to accessing care. METHODS: Cross-sectional data were collected on dental clinics in Pittsburgh, Pennsylvania, caring for Medicaid-insured children ≥1 year. Shortest distances, drive times, and bus travel between dental clinics and high-poverty census tracts were determined through geographical information systems analysis. Primary care clinic (PCC) survey data were analyzed for children's dental use. Demographic characteristics and travel-related variables were compared between children who had and had not been to a dentist. RESULTS: Ten dental clinics accepted Medicaid-insured children ≥1 year. Mean distance between high-poverty census tracts and their nearest clinic was 1.2 miles [standard deviation (SD) 0.2 miles], with mean bus travel time 15.6 minutes (SD 12.3 minutes). Overall, 46 percent of PCC children reported a dental visit, and this was not significantly different between those who lived in a high-poverty census tract versus those who did not (41 percent and 35 percent, respectively, P = 0.58). Children traveled a mean distance of 4.75 miles (SD 2.37 miles) to their dental clinic. Mean distance to their nearest dental clinic was 2.81 miles (SD 2.12 miles). CONCLUSION: Dental clinics in a high-resource area are in close proximity to where young Medicaid-insured children live; and distances between children's homes and dental clinics are not significantly different between children who had and had not reported a dental visit, suggesting that barriers persist despite close proximity. Regardless, closer proximity may contribute to the higher utilization of services observed compared with national rates.
OBJECTIVES: Examine dental utilization by Medicaid-insured children living in a high-resource area. Characterize distance and travel-related variables to accessing care. METHODS: Cross-sectional data were collected on dental clinics in Pittsburgh, Pennsylvania, caring for Medicaid-insured children ≥1 year. Shortest distances, drive times, and bus travel between dental clinics and high-poverty census tracts were determined through geographical information systems analysis. Primary care clinic (PCC) survey data were analyzed for children's dental use. Demographic characteristics and travel-related variables were compared between children who had and had not been to a dentist. RESULTS: Ten dental clinics accepted Medicaid-insured children ≥1 year. Mean distance between high-poverty census tracts and their nearest clinic was 1.2 miles [standard deviation (SD) 0.2 miles], with mean bus travel time 15.6 minutes (SD 12.3 minutes). Overall, 46 percent of PCC children reported a dental visit, and this was not significantly different between those who lived in a high-poverty census tract versus those who did not (41 percent and 35 percent, respectively, P = 0.58). Children traveled a mean distance of 4.75 miles (SD 2.37 miles) to their dental clinic. Mean distance to their nearest dental clinic was 2.81 miles (SD 2.12 miles). CONCLUSION: Dental clinics in a high-resource area are in close proximity to where young Medicaid-insured children live; and distances between children's homes and dental clinics are not significantly different between children who had and had not reported a dental visit, suggesting that barriers persist despite close proximity. Regardless, closer proximity may contribute to the higher utilization of services observed compared with national rates.