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Trends in the Receipt of Recommended Preventive Dental Care: The impact of State Children Health Insurance Program (SCHIP)

Chi-Chi Liao, MS, Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, 677 Huntington Ave, 7th floor, Boston, MA 02115, 617-987-0986, cliao@hsph.harvard.edu, Michael Lee Ganz, PhD, MS, Maternal & Child Health, Harvard School of Public Health, 677 Huntington Ave, Kresge 615, Boston, MA 02115, and Hongyu Jiang, PhD, Department of Biostatistics, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115.

Dental care for children accounts for approximately one-quarter of U.S. dental spending and is a major component of child health care costs. Income and racial disparities in expenditures favor higher income children despite Medicaid coverage for lower income children. High levels of reported out-of-pocket costs for Medicaid eligible children suggest that Medicaid fails to meet families’ needs in obtaining care. Meeting the oral health needs of poor children will require considerably greater expenditures, particularly through improved Medicaid financing and administration. The federal government has worked with state government on separate SCHIP programs, Medicaid expansions or combination of both programs to increase the coverage and also income level of eligibility for uninsured children. One focus of SCHIP is preventive dental services for uninsured children.

This paper assesses the impact of SCHIP program on the preventive dental services for children using the 1996-2000 Medical Expenditure Panel Survey.

We have found that SCHIP implementation is significant predictor of children utilization of preventive dental services including prophylaxes, fluoride treatments and sealants controlling for family size, age of the child, mother’s education attainment, payers and state level characteristics. Children eligible for SCHIP after SCHIP implementation are more likely to meet the preventive dental care guideline than children without SCHIP coverage before implementation. In addition, age, family size, race, mother’s education, insurance status, mother’s marital status, and metropolitan area are strongly associated with preventive dental utilization.

We conclude that SCHIP has been successfully increased the preventive dental services for uninsured kids under 200% Federal Poverty Line.

Learning Objectives:

Keywords: Oral Health, Children and Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

What's Going 'round in Oral Health?

The 132nd Annual Meeting (November 6-10, 2004) of APHA