title: Impact of chronic condition status and severity on the time to first dental visit for newly Medicaid-enrolled children in Iowa.
abstract: OBJECTIVE
  To assess the extent to which chronic condition (CC) status and severity affected how soon children had a dental visit after enrolling in Medicaid. Data Source. Enrollment and claims data (2003-2008) for newly Medicaid-enrolled children ages 3-14 in Iowa.
  
  
  METHODS
  3M Clinical Risk Grouping methods were used to identify CC status (no/yes) and CC severity (less severe/more severe). Survival analysis was used to identify the factors associated with earlier first dental visits after initially enrolling in Medicaid.
  
  
  RESULTS
  Children with a CC were 17 percent more likely to have earlier first dental visits after enrolling in Medicaid (p < .0001). There was no significant difference by CC severity. Children who lived in a dental health professional shortage area and those who did not utilize primary medical care had significantly later first Medicaid dental visits, whereas these factors failed to reach statistical significance for children with a CC.
  
  
  CONCLUSIONS
  While newly Medicaid-enrolled children with a CC were significantly more likely to have earlier first dental visits, we failed to detect a relationship between CC severity and the time to first Medicaid dental visit. The determinants of first Medicaid dental visits were heterogeneous across subgroups of newly Medicaid-enrolled children. Future studies should identify the sociobehavioral factors associated with CCs that are potential barriers to earlier first Medicaid dental visits for newly Medicaid-enrolled children.
authors.affiliation: School of Dentistry, Department of Dental Public Health Sciences, University of Washington, Seattle, WA 98105, USA. dchi@uw.edu
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Momany
authors.forename: John
authors.initials: J
authors.lastname: Neff
authors.forename: Michael P
authors.initials: MP
authors.lastname: Jones
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Slayton
authors.forename: Karin
authors.initials: K
authors.lastname: Weber-Gasparoni
authors.forename: Peter C
authors.initials: PC
authors.lastname: Damiano
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007484:Iowa; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D014481:United States