Impact of Chronic Condition Status and Severity on the Time to First Dental Visit for Newly Medicaid-Enrolled Children in Iowa
Donald L. Chi
School of Dentistry, Department of Dental Public Health Sciences, University of Washington, Box 357475, Seattle, WA 98105
Address correspondence to Donald L. Chi, D.D.S., Ph.D., School of Dentistry, Department of Dental Public Health Sciences, University of Washington, Box 357475, Seattle, WA 98105; e-mail: [email protected]. Elizabeth T. Momany, Ph.D., is with the Public Policy Center, University of Iowa, Iowa City, IA. John Neff, M.D., is with the School of Medicine, Department of Pediatrics, University of Washington, Seattle, WA. Michael P. Jones, Ph.D., is with the College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA. John J. Warren, D.D.S., M.S., is with the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA. Rebecca L. Slayton, D.D.S., Ph.D., and Karin Weber-Gasparoni, D.D.S., Ph.D., are with the College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA. Peter C. Damiano, D.D.S., M.P.H., is with the Public Policy Center, and the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA.
Search for more papers by this authorElizabeth T. Momany
Public Policy Center, University of Iowa, Iowa City, IA
Search for more papers by this authorJohn Neff
School of Medicine, Department of Pediatrics, University of Washington, Seattle, WA
Search for more papers by this authorMichael P. Jones
College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA
Search for more papers by this authorJohn J. Warren
College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorRebecca L. Slayton
College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorKarin Weber-Gasparoni
College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorPeter C. Damiano
Public Policy Center, and the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA.
Search for more papers by this authorDonald L. Chi
School of Dentistry, Department of Dental Public Health Sciences, University of Washington, Box 357475, Seattle, WA 98105
Address correspondence to Donald L. Chi, D.D.S., Ph.D., School of Dentistry, Department of Dental Public Health Sciences, University of Washington, Box 357475, Seattle, WA 98105; e-mail: [email protected]. Elizabeth T. Momany, Ph.D., is with the Public Policy Center, University of Iowa, Iowa City, IA. John Neff, M.D., is with the School of Medicine, Department of Pediatrics, University of Washington, Seattle, WA. Michael P. Jones, Ph.D., is with the College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA. John J. Warren, D.D.S., M.S., is with the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA. Rebecca L. Slayton, D.D.S., Ph.D., and Karin Weber-Gasparoni, D.D.S., Ph.D., are with the College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA. Peter C. Damiano, D.D.S., M.P.H., is with the Public Policy Center, and the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA.
Search for more papers by this authorElizabeth T. Momany
Public Policy Center, University of Iowa, Iowa City, IA
Search for more papers by this authorJohn Neff
School of Medicine, Department of Pediatrics, University of Washington, Seattle, WA
Search for more papers by this authorMichael P. Jones
College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA
Search for more papers by this authorJohn J. Warren
College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorRebecca L. Slayton
College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorKarin Weber-Gasparoni
College of Dentistry, Department of Pediatric Dentistry, University of Iowa, Iowa City, IA
Search for more papers by this authorPeter C. Damiano
Public Policy Center, and the College of Dentistry, Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA.
Search for more papers by this authorAbstract
Objective. To assess the extent to which chronic condition (CC) status and severity affected how soon children had a dental visit after enrolling in Medicaid.
Data Source. Enrollment and claims data (2003–2008) for newly Medicaid-enrolled children ages 3–14 in Iowa.
Study Design. 3M Clinical Risk Grouping methods were used to identify CC status (no/yes) and CC severity (less severe/more severe). Survival analysis was used to identify the factors associated with earlier first dental visits after initially enrolling in Medicaid.
Principal Findings. Children with a CC were 17 percent more likely to have earlier first dental visits after enrolling in Medicaid (p<.0001). There was no significant difference by CC severity. Children who lived in a dental health professional shortage area and those who did not utilize primary medical care had significantly later first Medicaid dental visits, whereas these factors failed to reach statistical significance for children with a CC.
Conclusion. While newly Medicaid-enrolled children with a CC were significantly more likely to have earlier first dental visits, we failed to detect a relationship between CC severity and the time to first Medicaid dental visit. The determinants of first Medicaid dental visits were heterogeneous across subgroups of newly Medicaid-enrolled children. Future studies should identify the sociobehavioral factors associated with CCs that are potential barriers to earlier first Medicaid dental visits for newly Medicaid-enrolled children.
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