title: Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans.
abstract: BACKGROUND
  Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008.
  
  
  METHODS
  Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received.
  
  
  RESULTS
  Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group.
  
  
  CONCLUSIONS
  DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees.
authors.affiliation: Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Bhagavatula
authors.affiliation: Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Qun
authors.initials: Q
authors.lastname: Xiang
authors.affiliation: Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Aniko
authors.initials: A
authors.lastname: Szabo
authors.affiliation: Delta Dental of Wisconsin, Stevens Point, WI, USA.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Eichmiller
authors.affiliation: Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Okunseri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007347:Insurance, Dental / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D011322:Primary Prevention; D014481:United States; D014922:Wisconsin
keywords: Medicaid; access to care; dental health professional shortage areas; dental insurance; dental utilization; oral health