Increasing access to dental care for medicaid preschool children: the Access to Baby and Child Dentistry (ABCD) program.
OBJECTIVE
Washington State's Access to Baby and Child Dent stry (ABCD) Program, first implemented in Spokane County in 1995, offers extended dental benefits to participating Medicaid-enrolled children and higher fees for certified providers. This study aimed to determine the program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge.


METHODS
The study used a posttest-only comparison group design. Trained interviewers conducted telephone interviews with 465 parents of chi dren ages 13 to 36 months (49% ABCD, 51% Medicaid-enrolled children not in ABCD). One year later, 282 of 465 parents completed a follow-up survey. Utilization and expenditures were calculated from Medicaid claims.


RESULTS
Forty-three percent of children in the ABCD Program visited a dentist in the follow-up year, compared with 12% of Medicaid-enrolled children not in the ABCD Program. An ABCD child was 5.3 times as likely to have had at least one dental visit as a child not in the program. ABCD children were 4 to 13 times as likely to have used specific dental services. Parents of ABCD children were more likely to report having ever tried to make a dental appointment, less likely to report that their children were fearful of the dentist, and were more satisfied, compared to parents of non-ABCD children.


CONCLUSIONS
The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction.
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195-7660, USA. grem@u.washington.edu
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D
Grembowski
P M
PM
Milgrom
D002675:Child, Preschool; D003258:Consumer Behavior / Q000706:statistics & numerical data; D019140:Dental Care for Children / Q000458:organization & administration* / Q000523:psychology / Q000706:statistics & numerical data; D005239:Fear; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008484:Medicaid / Q000458:organization & administration*; D010377:Pediatric Dentistry / Q000191:economics / Q000458:organization & administration*; D011203:Poverty; D015397:Program Evaluation; D012044:Regression Analysis; D013221:State Health Plans / Q000191:economics / Q000458:organization & administration; D014481:United States; D014861:Washington