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Racial and ethnic disparities in oral healthcare quality among children enrolled in Medicaid and CHIP
Author(s) -
Herndon Jill Boylston,
Ojha Diptee
Publication year - 2022
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.12522
Subject(s) - medicaid , ethnic group , medicine , health equity , demography , population , health care , context (archaeology) , logistic regression , gerontology , environmental health , public health , geography , nursing , archaeology , sociology , anthropology , economics , economic growth
Objectives Addressing inequities in oral health care requires identification of which populations are experiencing performance gaps and the extent of those gaps. This study used Dental Quality Alliance (DQA) measures to examine variations in quality by race and ethnicity. Methods We used eligibility and claims data for 2018 for children aged <21 years for state Medicaid/CHIP programs available through the Transformed Medicaid Statistical Information System. For a subset of states with sufficient data quality, we calculated DQA measures of utilization of services, oral evaluation, and topical fluoride. The measures were stratified by race and ethnicity, age, sex, geographic location, and language. We used bivariate logistic regression to analyze relative disparities. Results Variations in measure scores were noted between racial and ethnic groups. Measure scores were typically lower for non‐Hispanic black and American Indian/Alaskan Native children and higher for non‐Hispanic Asian and Hispanic children compared with non‐Hispanic white children. There also was variation in the patterns of disparities between states. More than two‐thirds of states had insufficient race and ethnicity data (>10% missing) to reliably report stratified measure scores. Conclusions Because disparities vary by state, each Medicaid/CHIP program should evaluate variations in care quality in the context of the population it serves. A critical first step is to improve collection of race and ethnicity. These measurements can be used to set improvement goals that not only raise quality of care for the population overall but also close gaps in performance between racial and ethnic groups.