title: County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: how does place affect use?
abstract: Little is known about how place affects childrens' access to dental care. We analyzed data for 25,908 Iowa Medicaid-enrolled children with chronic conditions to identify the county-level determinants of dental utilization. Our analyses suggest that higher levels of poverty and designation as a dental health professional shortage area at the county-level are associated with lower probability of child-level dental use. There are significant interactions between child-level race/ethnicity and county-level poverty as well as between child-level disability and county-level unemployment. We present a new descriptive model on dental utilization that emphasizes county-level factors as well as interactions between county-level and child-level factors.
authors.affiliation: Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195, USA. dchi@uw.edu
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
authors.forename: Brian
authors.initials: B
authors.lastname: Leroux
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology*; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D011204:Poverty Areas; D012959:Socioeconomic Factors; D014481:United States