title: The impact of a home visiting program on children's utilization of dental services.
abstract: BACKGROUND
  Child Health Investment Partnership (CHIP) of Roanoke Valley is a home visiting program that promotes children's health and family self-sufficiency. CHIP's Begin With a Grin program provides preventive dental services in the home (oral health anticipatory guidance and fluoride varnish) for children aged 0 to 6 years. The purpose of this study was to compare the dental utilization of Medicaid-enrolled children in CHIP versus Medicaid-enrolled children not in CHIP.
  
  
  METHODS
  Using the propensity score method, control subjects were selected from the statewide Medicaid database by using a caliper-matching algorithm. A vector of chosen covariates was used to match control subjects; these covariates included risk factors, estimated propensity score, age, race, gender, and days of Medicaid eligibility. Propensity scores were developed by using a logistic regression. Differences in dental utilization outcomes were tested: ≥1 dental claim (logistic regression) and number of dental claims (Poisson regression) for each subject within the test period.
  
  
  RESULTS
  When CHIP children were compared with Medicaid-only children, the CHIP child was 3 times more likely to have at least 1 dental visit (odds ratio: 3.0 [95% confidence interval: 1.9-4.7]) and have a higher number of dental claims (ratio of estimated average number of dental claims [cases/control]: 8.60/3.05 = 2.82 [95% confidence interval: 2.56-3.12]).
  
  
  CONCLUSIONS
  A home visiting model can introduce children and their families to dental prevention, improve dental health literacy, establish a dental home, and provide application of fluoride varnish.
authors.affiliation: DDS, Department of Pediatric Dentistry, VCU School of Dentistry, 521 N. 11th St, Richmond, VA 23298-0566. thbrickhouse@vcu.edu.
authors.forename: Tegwyn H
authors.initials: TH
authors.lastname: Brickhouse
authors.forename: Robin R
authors.initials: RR
authors.lastname: Haldiman
authors.forename: Bhanu
authors.initials: B
authors.lastname: Evani
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D019140:Dental Care for Children / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D062489:Health Impact Assessment / Q000379:methods / Q000706:statistics & numerical data*; D057220:Health Literacy / Q000379:methods; D006699:Home Care Services / Q000706:statistics & numerical data*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D014481:United States; D014768:Virginia / Q000453:epidemiology
keywords: children; dental; home visiting; utilization