title: Impact of chronic condition status and severity on dental utilization for Iowa Medicaid-enrolled children.
abstract: BACKGROUND
  Although Medicaid-enrolled children with a chronic condition (CC) may be less likely to use dental care because of factors related to their CC, dental utilization for this population is poorly understood.
  
  
  OBJECTIVE
  To assess the relationship between CC status and CC severity, respectively, on dental utilization for Iowa Medicaid-enrolled children.
  
  
  METHODS
  Retrospective cohort study of Iowa Medicaid data (January 1, 2003 to December 31, 2006).
  
  
  METHODS
  Medicaid-enrolled children aged 3 to 14 (N = 71,115) years.
  
  
  METHODS
  The 3M Corporation Clinical Risk Grouping methods were used to assess CC status (no/yes) and CC severity (episodic/life-long/malignancy/complex). The outcome variable was any dental utilization in 2006. Secondary outcomes included use of diagnostic, preventive, routine restorative, or complex restorative dental care.
  
  
  RESULTS
  After adjusting for model covariates, Iowa Medicaid-enrolled children with a CC were significantly more likely to use each type of dental care except routine restorative care (P = 0.86) than those without a CC, although the differences in the odds were small (4%-6%). Compared with Medicaid-enrolled children with an episodic CC, children with a life-long CC were less likely to use routine restorative care (P < 0.0001), children with a malignancy were more likely to use complex restorative care (P < 0.03), and children with a complex CC were less likely to use each type of dental care except complex restorative care (P = 0.97).
  
  
  CONCLUSIONS
  There were differences in dental utilization for Iowa Medicaid-enrolled children by CC status and CC severity. Children with complex CCs were the least likely to use dental care. Future research efforts should seek to understand why subgroups of Medicaid-enrolled children with a CC exhibit lower dental utilization.
authors.affiliation: Department of Dental Public Health Sciences, School of Dentistry, The University of Washington, Seattle, WA 98185, 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 / Q000453:epidemiology; D015331:Cohort Studies; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003753:Dental Health Surveys; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D007484:Iowa / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000458:organization & administration; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014481:United States