Time to first dental visit after initially enrolling in Medicaid and S-SCHIP.
BACKGROUND
Accessing dental care is a significant problem for children in Medicaid and S-SCHIP (Separate State Children's Health Insurance Program). Previous studies have indicated that the design of the Medicaid or S-SCHIP dental program can have an impact on the ability to use services.


OBJECTIVE
To evaluate the factors related to how quickly children had any dental visit and had a preventive dental visit after first enrolling in the Iowa Medicaid and S-SCHIP programs. The primary question was whether the structure of the dental plan was related to improved access to care.


METHODS
Iowa Medicaid and S-SCHIP dental claims and enrollment files for FY 2001 through 2003 were used to identify children who were newly enrolled in the programs and their use of dental services. Factors related to the time to a child's first dental visit were analyzed using survival analytic techniques.


RESULTS
After 6 months in the program, between 21% and 36% of children had received their first dental visit, depending on their dental plan. This increased from 39% to 56% after 1 year. Based on the survival analysis, earlier dental utilization was related to the type of plan in which the child was enrolled as well as the child's age, race, and urban/rural location.


CONCLUSIONS
Children in the S-SCHIP 2 dental plan, which had an open provider network and paid dentists' full charges, were most likely to have had a dental visit sooner after enrollment. States looking for options to improve access to dental care in their Medicaid and S-SCHIP programs should consider contracting with dental plans with these features.
Damiano
Peter C
PC
Public Policy Center, University of Iowa, Iowa City, Iowa 52242, USA. peter-damiano@uiowa.edu
Momany
Elizabeth T
ET
Carter
Knute D
KD
Jones
Michael P
MP
Askelson
Natoshia M
NM
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007484:Iowa; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D013221:State Health Plans / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States