The effect of two publicly funded insurance programs on use of dental services for young children.
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.


METHODS
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.


METHODS
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.


RESULTS
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.
Brickhouse
Tegwyn H
TH
Virginia Commonwealth University School of Dentistry, Richmond, VA 23298-0566, USA.
Rozier
R Gary
RG
Slade
Gary D
GD
D002675:Child, Preschool; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007347:Insurance, Dental / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D009657:North Carolina; D012189:Retrospective Studies; D013221:State Health Plans / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States