Beth M McManus1, Donald Chi2, Adam Carle3. 1. Department of Health Systems, Management and Policy, Colorado School of Public Health and Children's Outcomes Research Group, Children's Hospital Colorado, 13001 E. 17th Place, MS B117, Aurora, CO, 80045, USA. beth.mcmanus@ucdenver.edu. 2. Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA. 3. Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Abstract
OBJECTIVE: To determine if Medicaid eligibility is associated with unmet preventive dental care need for Medicaid-enrolled CSHCN. METHODS: We analyzed the 2009-2010 National Survey of CSHCN and focused on Medicaid-enrolled children ages 3-17. The outcome measure was parent-reported unmet need for preventive dental care. The predictor variable was state Medicaid eligibility criteria, categorized as broad [>250 % Federal Poverty Level (FPL)], moderate (200-249 % FPL), and narrow (<200 % FPL). Multiple variable multilevel logistic regression models estimated the association between state-level eligibility criteria and variability in unmet need. RESULTS: The multilevel models indicated no significant association between Medicaid eligibility criteria and unmet preventive dental care need. CSHCN with more severe chronic health conditions had significantly greater odds of unmet need (OR 1.52; 95 % CI 1.28, 1.82) and CSHCN with a medical home had significantly lower odds (OR 0.61; 95 % CI 0.50, 0.75). CONCLUSIONS FOR PRACTICE: There is significant state variability in unmet need for preventive dental care for Medicaid-enrolled CSHCN. Broadening Medicaid eligibility criteria alone is not likely to address the preventive dental care needs of CSHCN, which has policy implications for improving oral health disparities for publicly-insured CSHCN.
OBJECTIVE: To determine if Medicaid eligibility is associated with unmet preventive dental care need for Medicaid-enrolled CSHCN. METHODS: We analyzed the 2009-2010 National Survey of CSHCN and focused on Medicaid-enrolled children ages 3-17. The outcome measure was parent-reported unmet need for preventive dental care. The predictor variable was state Medicaid eligibility criteria, categorized as broad [>250 % Federal Poverty Level (FPL)], moderate (200-249 % FPL), and narrow (<200 % FPL). Multiple variable multilevel logistic regression models estimated the association between state-level eligibility criteria and variability in unmet need. RESULTS: The multilevel models indicated no significant association between Medicaid eligibility criteria and unmet preventive dental care need. CSHCN with more severe chronic health conditions had significantly greater odds of unmet need (OR 1.52; 95 % CI 1.28, 1.82) and CSHCN with a medical home had significantly lower odds (OR 0.61; 95 % CI 0.50, 0.75). CONCLUSIONS FOR PRACTICE: There is significant state variability in unmet need for preventive dental care for Medicaid-enrolled CSHCN. Broadening Medicaid eligibility criteria alone is not likely to address the preventive dental care needs of CSHCN, which has policy implications for improving oral health disparities for publicly-insured CSHCN.
Entities:
Keywords:
Dental care; Medicaid; Multi-level models; National Survey of Children with Special Health Care Needs
Authors: Donald L Chi; Elizabeth T Momany; Raymond A Kuthy; Jane M Chalmers; Peter C Damiano Journal: J Public Health Dent Date: 2010 Impact factor: 1.821
Authors: Donald L Patrick; Rosanna Shuk Yin Lee; Michele Nucci; David Grembowski; Carol Zane Jolles; Peter Milgrom Journal: BMC Oral Health Date: 2006-06-15 Impact factor: 2.757