Preventive dental care for young, Medicaid-insured children in Washington state.
BACKGROUND
Children from low-income families face barriers to preventive dental care (PDC) and are disproportionately affected by dental caries. The Access to the Baby and Childhood Dentistry (ABCD) program of Washington State is targeted to Medicaid-insured children <6 years of age to improve their access to PDC.


OBJECTIVE
To test the hypothesis that residing in an ABCD county improves the likelihood of receiving PDC and, to compare PDC use among young, Medicaid-insured children in Washington to national statistics.


METHODS
We extracted 2003 Washington Medicaid dental claims for continuously enrolled children <or=6 years of age. Multivariable analysis was performed to identify variables independently associated with >or=1 preventive dental visit (PDV) in 2003. For national comparison, we used the 2003 Medical Expenditure Panel Survey (MEPS).


RESULTS
Among Medicaid-insured children <or=6 yrs of age from WA counties with ABCD program, 45% had at least 1 PDV compared with 36% from non-ABCD counties (P < .001) and 37% of US children with continuous private insurance (P < .001). There were significantly higher adjusted odds of a PDV for children from ABCD counties relative to non-ABCD counties (odds ratio: 1.30 [95% confidence interval: 1.05-1.60]).


CONCLUSIONS
We confirmed our hypothesis that residing in an ABCD county was associated with a higher likelihood of having >or=1 PDV in 2003. We also found that significantly more children in established ABCD counties received PDC compared with privately insured US children. These findings provide additional evidence that the ABCD program reduces disparities in dental care access among young, Medicaid-insured children in Washington and point to the importance of expanding the ABCD program to other states.
Lewis
Charlotte
C
Division of General Pediatrics, Department of Pediatrics, Child Health Institute, School of Public Health, University of Washington, Seattle, Washington 98195, USA. cwlewis@u.washington.edu
Teeple
Elizabeth
E
Robertson
Andrea
A
Williams
Alexis
A
D019140:Dental Care for Children / Q000458:organization & administration*; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008484:Medicaid; D010377:Pediatric Dentistry / Q000458:organization & administration; D011314:Preventive Health Services / Q000458:organization & administration*; D014481:United States; D014861:Washington