The effect of publicly financed insurance programs on the use of dental services and dental health outcomes of young children.

摘要

Numerous barriers threaten access to oral health services for young children. Enacted policies regarding the coverage of oral health services do not necessarily translate into realized access for children. Low levels of provider participation and reimbursement rates in publicly funded programs are key factors in this unrealized access to oral health services. In addition, children enrolled in these public programs are from lower socioeconomic families and tend to face multiple barriers to accessing health care.; North Carolina's S-CHIP program, or NC Health Choice (NCHC), provides health services, including dental, through NC Blue Cross/Blue Shield's private insurance program. The other public health insurance program is the state Medicaid program. This investigation represents an in-depth comparison of children's receipt of dental services through the NC Medicaid Program or the NCHC Program. This analysis will link enrollment files for children, ages 1–5, enrolled in Medicaid or NCHC to their dental claims from October 1999 through September 2000, creating person-level data on the utilization of dental services. The first part of this investigation is a methodological paper on the development of measurements for enrollment characteristics to more precisely measure dental utilization among eligible Medicaid populations. The second paper compares the use of dental services between Medicaid and NCHC for children 1 to 5 years of age, while the third paper compares differences in specific process and outcome measures of plan performance between the two insurance programs. The result of this dissertation project is an in-depth comparison of dental utilization, established pediatric oral health performance measures, and dental health status measured by tooth mortality for children enrolled in either the NC Medicaid program or NCHC. This study provides an opportunity to determine the benefits of public dental insurance for low-income children when structured similar to private insurance.