Impact of chronic condition status and severity on dental treatment under general anesthesia for Medicaid-enrolled children in Iowa state.
OBJECTIVE
To assess the impact of chronic condition (CC) status and CC severity, respectively, on the odds of receiving dental treatment under general anesthesia (GA) for Medicaid-enrolled children by age group.


METHODS
This was a retrospective analysis of Iowa Medicaid-enrolled children <15 years (n = 62 721) from 2005 to 2008. 3M Clinical Risk Grouping Software identified each child's CC status (yes/no) and assigned children with a CC into a hierarchal CC severity group (episodic/life-long/complex). Multiple variable logistic regression models were used to identify the determinants of dental treatment under GA.


RESULTS
Less than 1% of children received dental treatment under GA. While there was no significant difference in dental treatment under GA by CC status for children <6, those with a life-long CC were twice as likely to receive dental treatment under GA as demographically similar children with an episodic CC (P < 0.05). Children ages 6-14 with a CC were three times as likely as those without a CC to receive treatment under GA (P = 0.001). There was also a direct relationship between CC severity and dental treatment under GA use for older children. Those living in nonmetropolitan areas were more likely to receive treatment under GA as were children who previously received dental treatment under GA.


CONCLUSIONS
Chronic condition status and severity were more important determinants of dental treatment under GA for Medicaid-enrolled children ages 6-14 than for those <6. Understanding these relationships is a critical step in developing clinical strategies and interventions aimed at preventing dental disease for Medicaid-enrolled children whose reasons for needing dental treatment under GA are modifiable.
Chi
Donald L
DL
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98195, USA. dchi@u.washington.edu
Momany
Elizabeth T
ET
Neff
John
J
Jones
Michael P
MP
Warren
John J
JJ
Slayton
Rebecca L
RL
Weber-Gasparoni
Karin
K
Damiano
Peter C
PC
D000293:Adolescent; D000367:Age Factors; D000768:Anesthesia, General / Q000191:economics* / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019140:Dental Care for Children / Q000191:economics* / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000191:economics / Q000628:therapy; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007484:Iowa; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D015233:Models, Statistical; D012044:Regression Analysis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States