title: Dental care utilization and expenditures in children with special health care needs.
abstract: BACKGROUND
  The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures.
  
  
  METHODS
  The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure.
  
  
  RESULTS
  Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure.
  
  
  CONCLUSIONS
  Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics.
  
  
  CONCLUSIONS
  The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to include broad-based provider and parent initiatives.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. hbeil@email.unc.edu
authors.forename: Heather
authors.initials: H
authors.lastname: Beil
authors.forename: Michelle
authors.initials: M
authors.lastname: Mayer
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data*; D003730:Dental Care for Persons with Disabilities / Q000191:economics / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005102:Health Expenditures / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007182:Income; D007347:Insurance, Dental; D008297:Male; D020380:Needs Assessment; D010290:Parents / Q000193:education; D011203:Poverty; D011336:Probability; D044469:Racial Groups; D014481:United States