An ABCD program to increase access to dental care for children enrolled in Medicaid in a rural county.
OBJECTIVE
The Access to Baby and Child Dentistry (ABCD) Program addresses the needs of families in obtaining dental care. In this study, the program was evaluated in rural Stevens County, Washington. Aims were to assess utilization of dental services, average dental expenditures per child, and oral health status.


METHODS
Medicaid-enrolled children aged 1-4 years were randomly assigned to the ABCD program (n=216) or to regular benefits (n=221). An outreach worker contacted each ABCD family and provided an orientation. Dental care utilization and expenditures were calculated from claims. A posttest-only design was used to evaluate oral health status.


RESULTS
An enrollment effect was seen in ABCD, but the difference between groups was not sustained. There was a doubling of utilization between groups for the youngest cohort, while the others showed no differences. In the first year the rate was higher for the entire ABCD group than for the children not in ABCD (34.0% vs 24.7%). Thirty-three percent of ABCD children (70/212) who had visited the dentist had >1 appointment compared to 21.5 percent (47/219) for the children not in ABCD who had visited the dentist. There was no overall difference in expenditures, while expenditures for preventive services were greater for ABCD. ABCD children had fewer teeth with initial caries. The average incremental cost per child per initial lesion prevented was 31.44 dollars.


CONCLUSIONS
ABCD most benefited the youngest cohort of children and improved health.
Kaakko
Tarja
T
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195, USA.
Skaret
Erik
E
Getz
Tracy
T
Hujoel
Philippe
P
Grembowski
David
D
Moore
Carree S
CS
Milgrom
Peter
P
D002675:Child, Preschool; D015331:Cohort Studies; D004245:DMF Index; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures; D006293:Health Promotion; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007223:Infant; D007342:Insurance Benefits; D007344:Insurance Claim Reporting; D008484:Medicaid / Q000191:economics; D009909:Oral Health; D011203:Poverty; D011313:Preventive Dentistry / Q000191:economics; D019035:Rural Health Services / Q000191:economics / Q000706:statistics & numerical data; D014481:United States; D014861:Washington