Does Medicaid improve utilization of medical and dental services and health outcomes for Medicaid-eligible children in the United States?
BACKGROUND
Data are lacking to support the contention that Medicaid services improve utilization of healthcare services and result in better health.


OBJECTIVE
To compare sociodemographic, utilization of healthcare services and health status characteristics among Medicaid-eligible children.


METHODS
The third National Health and Nutrition Examination Survey included 2821 children 2-16 years of age eligible for Medicaid. The main outcome measures are annual physician visit, annual dentist visit, general health status, oral health status, asthma (second most common childhood disease), dental caries (most common childhood disease), asthma treatment needs, and dental treatment needs. We quantified the association of these outcome measures with Medicaid insurance status and sociodemographic status using multiple logistic regression modeling, taking into account the complex survey design and sample weights.


RESULTS
Among Medicaid-eligible children, 27% were uninsured. Among uninsured Medicaid-eligible children, 62% had an annual physician visit, 32% had an annual dentist visit, 10% needed asthma treatment, and 57% needed dental treatment. Among insured Medicaid-eligible children, 81% had an annual physician visit, 39% had an annual dentist visit, 13% needed asthma treatment, and 42% needed dental treatment. After simultaneously taking into account other characteristics, uninsured Medicaid-eligible children were more likely to not have an annual physician visit (OR(NoMDvisit) = 2.21; 1.26-3.90), and to need dental treatment (OR(DentalNeed) = 1.57; 1.13-2.18).


CONCLUSIONS
This USA population-based study found disparities exist within Medicaid's services between utilization of dental and medical services. Medicaid insurance improved utilization of medical services, but did not improve the utilization of dental services. This suggests that Medicaid insurance does not improve access to dental services for poor children.
Fisher
Monica A
MA
Case Western Reserve University, Department of Orthodontics, Cleveland, OH 44106-4905, USA. monica.fisher@case.edu
Mascarenhas
Ana K
AK
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology*; D003752:Dental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009909:Oral Health; D014481:United States / Q000453:epidemiology