Barriers to Child Participation in a Medicaid Program Providing Oral Health Care in Medical Offices Public Deposited

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  • February 26, 2019
  • Seagroves, Jackson Tyler
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Background: Dental caries, commonly known as tooth decay, is one of the most prevalent chronic diseases in the United States despite being largely preventable. Early childhood caries (ECC) are particularly detrimental to pediatric health and are more prevalent among children of lower socioeconomic status, presenting a problem to poorer states with a low dentist-to-population ratio such as North Carolina (NC). Into the Mouths of Babes (IMB) is an NC program that addresses ECC and dentist shortage by reimbursing physicians for administering preventive dental treatments and providing oral health education to children enrolled in Medicaid. Objective: This study determines the effect of distance a child must travel to an IMB provider on utilization of IMB services, controlling for dentist utilization and demographic factors. Data sources: Claims data from 2013 to 2015 for children who utilized IMB services in North Carolina. Methods: This retrospective longitudinal study used data provided by North Carolina Division of Medical Assistance (NC-DMA), the organization that administers Medicaid in NC. A zero-truncated Poisson regression model was used to determine the effect of distance to an IMB provider on number of IMB visits, while including dentist visits, age at first IMB visit, race, ethnicity, and gender as predictors. Results: Distance travelled to an IMB provider slightly decreased IMB utilization. The most influential predictor of IMB utilization was a child’s utilization of dental services. Demographic factors such as race and ethnicity were related to IMB utilization. Conclusions: These results show that there is a substantial relationship between dentist visits and utilization of IMB services; future research should investigate this relationship. Travel distance does not appear to be an influential barrier to IMB participation, so NC-DMA and state policymakers should consider focusing on reducing other barriers to pediatric access to IMB services.
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  • In Copyright
  • Funding: None
  • White, Benjamin
  • Bachelor of Science in Public Health
Honors level
  • Honors
Degree granting institution
  • University of North Carolina at Chapel Hill
  • 30 p.

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