Washington State Foster Care: Dental Utilization and Expenditures

Details

• Personal Author:
  Chi DL ; Grembowski D ; Huebner CE ; Melbye MLR ; Milgrom P
• Description:
  Objectives: To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). Methods: This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages <18 years enrolled in the WA FC program for >/=11 months (N = 10,177). Regression models were used to examine associations between utilization and expenditures and sex, race, age group, Supplemental Security Income (SSI) (i.e., disability), substance abuse, behavior problems, placement setting (Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Results: Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population <20 K [ARR = 1.20 95% CI(1.12, 1.30)]. Associated with expenditures (P < 0.05) were: ages 0-2 years [-$153.66, 95% CI(-$168.33, -$139.00)], 3-5 years [-$98.71, 95% CI(-$116.78, -$80.65)], 6-11 years [-$16.83 95% CI(-$33.52, -$0.14)]; African American [-$32.05 95% CI(-$47.99, -$16.12)]; Kinship Care [$28.57 95% CI($14.00, $43.15)]. Conclusions: Most children enrolled in WA FC for >/=11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. [Description provided by NIOSH]
• Subjects:
  Dental Offices Healthcare Disparities Occupational Health Race Factors Safety Sex Characteristics
• Keywords:
  Access To Health Care Author Keywords: Foster Home Care Children Delivery Of Dental Care Dental Care For Children Dental Health Dentistry Health Disparities Oral Health Pediatric Dentistry Racial Factors Sex Factors

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• ISSN:
  0022-4006
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  93-101
• Volume:
  74
• Issue:
  2
• NIOSHTIC Number:
  nn:20056970
• Citation:
  J Public Health Dent 2014 Spring; 74(2):93-101
• Contact Point Address:
  Dr. Molly Lynn Rose Melbye, Oral Health Sciences, University of Washington, 1959 NE Pacific Street, Box 357475, Seattle,WA 98195
• Email:
  melbye@uw.edu
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Public Health Dentistry
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f2a77775854c598d39b9bb9538f7b6ca465cf66754323d9d393bf5376549032e84b1556c23c19a9045b1e3b956c63f3040b51f34322e742f89b1abcabe2b310f
• Download URL:
  https://stacks.cdc.gov/view/cdc/214458/cdc_214458_DS1.pdf
• File Type:
  [PDF - 92.42 KB ]