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VOLUME 46 | NUMBER 2 | APRIL 2011


Impact of Chronic Condition Status and Severity on the Time to First Dental Visit for Newly Medicaid-Enrolled Children in Iowa

Keywords: Medicaid; utilization; dental health services; disabled children; survival analysis

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="there" was="was" no="no" significant="significant" difference="difference" by="by" cc="cc" severity.="severity." lived="lived" in="in" health="health" professional="professional" shortage="shortage" area="area" and="and" those="those" who="who" did="did" not="not" utilize="utilize" primary="primary" medical="medical" care="care" had="had" significantly="significantly" later="later" first="first" medicaid="medicaid" dental="dental" visits,="visits," whereas="whereas" these="these" factors="factors" failed="failed" to="to" reach="reach" statistical="statistical" significance="significance" for="for" children="children" with="with" a="a" cc.</p="cc.&lt;/p">

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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