title: State Medicaid Eligibility Criteria and Unmet Preventive Dental Care Need for CSHCN.
abstract: OBJECTIVE
  To determine if Medicaid eligibility is associated with unmet preventive dental care need for Medicaid-enrolled CSHCN.
  
  
  METHODS
  We analyzed the 2009-2010 National Survey of CSHCN and focused on Medicaid-enrolled children ages 3-17. The outcome measure was parent-reported unmet need for preventive dental care. The predictor variable was state Medicaid eligibility criteria, categorized as broad [>250 % Federal Poverty Level (FPL)], moderate (200-249 % FPL), and narrow (<200 % FPL). Multiple variable multilevel logistic regression models estimated the association between state-level eligibility criteria and variability in unmet need.
  
  
  RESULTS
  The multilevel models indicated no significant association between Medicaid eligibility criteria and unmet preventive dental care need. CSHCN with more severe chronic health conditions had significantly greater odds of unmet need (OR 1.52; 95 % CI 1.28, 1.82) and CSHCN with a medical home had significantly lower odds (OR 0.61; 95 % CI 0.50, 0.75).
  
  
  CONCLUSIONS
  There is significant state variability in unmet need for preventive dental care for Medicaid-enrolled CSHCN. Broadening Medicaid eligibility criteria alone is not likely to address the preventive dental care needs of CSHCN, which has policy implications for improving oral health disparities for publicly-insured CSHCN.
authors.affiliation: Department of Health Systems, Management and Policy, Colorado School of Public Health and Children's Outcomes Research Group, Children's Hospital Colorado, 13001 E. 17th Place, MS B117, Aurora, CO, 80045, USA. beth.mcmanus@ucdenver.edu.
authors.forename: Beth M
authors.initials: BM
authors.lastname: McManus
authors.affiliation: Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Chi
authors.affiliation: Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Carle
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children; D003730:Dental Care for Persons with Disabilities; D019988:Children with Disabilities / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D055361:Multilevel Analysis; D020380:Needs Assessment; D010290:Parents; D014481:United States
keywords: Dental care; Medicaid; Multi-level models; National Survey of Children with Special Health Care Needs