Address correspondence to Tegwyn H. Brickhouse, D.D.S., Ph.D., Assistant Professor, Pediatric Dentistry, Virginia Commonwealth University School of Dentistry, 521 N. 11th St., Woods Bldg. 317, Richmond, VA 23298-0566. R. Gary Rozier D.D.S., Professor, is with Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Gary D. Slade, BDSc, D.P.H., Ph.D., is with the Australian Research Centre for Population Oral Health, Dental School, University of Adelaide, South Australia, Australia.
The Effect of Two Publicly Funded Insurance Programs on Use of Dental Services for Young Children
Article first published online: 20 JUN 2006
Health Services Research
Volume 41, Issue 6, pages 2033–2053, December 2006
How to Cite
Brickhouse, T. H., Rozier, R. G. and Slade, G. D. (2006), The Effect of Two Publicly Funded Insurance Programs on Use of Dental Services for Young Children. Health Services Research, 41: 2033–2053. doi: 10.1111/j.1475-6773.2006.00586.x
- Issue published online: 20 JUN 2006
- Article first published online: 20 JUN 2006
- Oral health;
- dental services;
- access to dental care
Objective. The purpose of this study is to compare the use of dental services for preschool aged children enrolled in North Carolina Medicaid, a traditional program based on a fee-for-service schedule, and North Carolina Health Choice (NCHC), an State Children's Health Insurance Program (S-CHIP) dental insurance program structured similarly to private insurance.
Study Population. All children (165,858) 1–5 years of age enrolled in Medicaid and S-CHIP (NCHC) at some time during one study year (October 1, 1999–September 30, 2000).
Data Sources/Extraction Methods. Medicaid and NCHC enrollment and dental claims files were obtained for individual children.
Study Design. An observational study with a retrospective cohort design. Use of dental services for each child was measured as having at least one dental claim during the outcome period (October 1, 1999–September 30, 2000). Multivariable logistic regression models were developed to compare the effect of two differently administered insurance programs on the use of dental services, controlling for demographic, enrollment, and county characteristics.
Principle Findings. Children enrolled solely in S-CHIP (NCHC) were 1.6 times more likely (95 percent confidence intervals (CI)=1.50–1.79) to have a dental visit than those enrolled solely in Medicaid. Prediction models for children enrolled for 12 months indicated that those enrolled in S-CHIP (NCHC) had a significantly higher probability of having a dental visit (50 percent) than those enrolled in both plans (44 percent) or Medicaid only (39 percent), a trend found in all age groups.
Conclusions. The S-CHIP (NCHC) program appears to provide children with increased access to dental care compared to children in the Medicaid program.