Barriers to dental care for children with medical assistance

[摘要] Disparities in access to dental care between children with private dental insurance and children with Medical Assistance (MA) exist.This was highlighted in the 2000 Surgeon General’s report on Oral Health, and there have been efforts to get more children with MA to the dentist yearly.Since 2009 Medicaid and CHIP are required to provide dental insurance to children enrolled in their plans.This has raised the rates of children with MA who see a dentist each year from 36% to ~50%.This is well below the ~90% of children with private dental insurance who see a dentist yearly.This raises the question: why does this disparity exist when children with MA have dental insurance?This study sought to determine if secret shopper surveys and geospatial analysis could be utilized to determine barriers to dental care for children with MA.Ninety-eight dental practices in Allegheny County were identified as accepting MA, providing access to 205 dentists and 6,839.5 hours of availability each week.Many of these dental practices had incorrect information on Managed Care Organization websites, and some dental practices actively limit when children with MA can be seen.This study also sought to determine if access by proximity is a barrier.A geospatial analysis was used to determine if children have access to care based on a distance of 15 miles, or 30-minute drive or transit time.This analysis showed that if children rely on public transportation to see a dentist, then children in certain zip codes throughout the county do not have adequate access.An analysis of how dentists and hours would need to be redistributed throughout the county to provide equal access showed that the zip codes with the most children with MA have access to the least number of dentists and hours needed.This was by distance, drive, and transit times.The public health importance of this study is that secret shopper and geospatial analysis can be used to identify potential barriers to dental care.It identified that proximity may be one of the biggest limiting factors, especially for children who rely on public transportation.

[发布机构] the University of Pittsburgh