title: Preventive dental utilization for Medicaid-enrolled children in Iowa identified with intellectual and/or developmental disability.
abstract: OBJECTIVE
  To compare preventive dental utilization for children with intellectual and/or developmental disability (IDD) and those without IDD and to identify factors associated with dental utilization.
  
  
  METHODS
  We analyzed Iowa Medicaid dental claims submitted during calendar year (CY) 2005 for a cohort of children ages 3-17 who were eligible for Medicaid for at least 11 months in CY 2005 (n = 107,605). A protocol for identifying IDD children was developed by a group of dentists and physicians with clinical experience in treating children with disabilities. Utilization rates were compared for the two groups. Crude and covariate-adjusted odds ratios were estimated using conditional logistic regression modeling.
  
  
  RESULTS
  A significantly higher proportion of non-IDD children received preventive care than those identified as IDD (48.6 percent versus 46.1 percent; P < 0.001). However, the final model revealed no statistically significant difference between the two groups. Factors such as older age, not residing in a dental Health Professional Shortage Area, interaction with the medical system, and family characteristics increased one's likelihood of receiving preventive dental care.
  
  
  CONCLUSIONS
  Although IDD children face additional barriers to receiving dental care and may be at greater risk for dental disease, they utilize preventive dental services at the same rate as non-IDD children. Clinical and policy efforts should focus on ensuring that all Medicaid-enrolled children receive need-appropriate levels of preventive dental care.
authors.affiliation: Department of Pediatric Dentistry, College of Dentistry, Public Policy Center, The University of Iowa, IA 52246, USA. donald-chi@uiowa.edu
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Momany
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Kuthy
authors.forename: Jane M
authors.initials: JM
authors.lastname: Chalmers
authors.forename: Peter C
authors.initials: PC
authors.lastname: Damiano
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003730:Dental Care for Persons with Disabilities / Q000706:statistics & numerical data*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007484:Iowa; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D016017:Odds Ratio; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014481:United States
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