Dental Services, Costs, and Factors Associated with Hospitalization for Medicaid-eligible Children, Louisiana 1996–97


Send correspondence and reprint requests to Dr. Griffin, Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations and Research Branch, 4770 Buford Highway, MS F10, Chamblee, GA 30341. E-mail: Drs. Gooch and Beltrán are affiliated with the Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations, and Research Branch. Dr. Barsley is with the Louisiana Department of Health and Hospitals. Dr. Sutherland is an HRSA regional dental consultant. Partial results for 3-year-old children were presented in a poster discussion session at the 77th General Session and Exhibition of the International Association for Dental Research, March 13, 1999, in Vancouver, Canada.


Objective: This study compared types and costs of dental services rendered to children who had received care in a hospital operating room (H) with children who had not (NH). Methods: The study population consisted of all children aged 1–5 years who received a dental service reimbursed by the Louisiana Medicaid EPSDT program from October 1996 through September 1997. Claim files were provided by the Louisiana Bureau of Health Services Financing. A treatment intensity index [TII=3*(# extractions) + 2*(# pulpotomies +# crowns) +# simple restorations] was calculated for H children (n=2,142) and NH children (n=38,423). Using logistic regression, a dichotomous hospitalization variable (H vs NH) was regressed against treatment intensity and selected personal and parish (county) characteristics for each of the five age groups. Total and average reimbursement per child were calculated for both groups of children, by age. Results: The mean treatment intensity scores for Hand NH children were 24.02 (SD=11.82) and 2.16 (SD=4.78), respectively. For all age groups, children with treatment intensity scores greater than 8 were at least 132 times more likely to be hospitalized than were children with scores less than or equal to 8. The mean cost for care provided to H children was $1,508 compared with $104 for NH. Total costs for dental care rendered to H children (5% of the study population) were $3,229,851 (45% of total dental costs for the study population). Conclusion: Reducing severe caries through early interventions could provide substantial cost savings.