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Washington state foster care: dental utilization and expenditures
Author(s) -
Melbye Molly L.R.,
Chi Donald L.,
Milgrom Peter,
Huebner Colleen E.,
Grembowski David
Publication year - 2013
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/jphd.12027
Subject(s) - medicine , medicaid , confidence interval , relative risk , demography , odds ratio , population , gerontology , environmental health , health care , sociology , economics , economic growth
Abstract 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 M edicaid 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, S upplemental S ecurity I ncome ( SSI ) (i.e., disability), substance abuse, behavior problems, placement setting ( F oster H ome C are, K inship C are, G roup C are, O ther), 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)]; N ative A merican [ ARR = 0.85, 95% CI (0.80, 0.91)]; SSI [ ARR = 1.10, 95% CI (1.04, 1.17)]; K inship C are [ ARR = 0.94, 95% CI (0.90, 0.98)]; G roup C are [ 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.