| 1497 Quality of Care for Medicaid-Enrolled Children in New Hampshire (NH) | ||
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D.L. CHI, University of Washington, School of Dentistry, Seattle, USA, and P. MILGROM, University of Washington, Seattle, USA Objectives: Our goal is to measure differences in care provided by pediatric and general dentists to Medicaid-enrolled children in NH. We investigate the hypothesis of no difference in quality of care provided by specialists and generalists. This research is part of a court-ordered monitoring process to evaluate dental care for Medicaid-enrolled children. Methods: Medicaid Fee-for-Service files for 02/01/2002-01/312003 were studied for children < 21 years old (n=12,964) who were seen by a pediatric or general dentist and for whom there was at least 1 paid claim. Five measures of care quality were constructed: dental home, comprehensive/periodic evaluations, prophylaxis, fluoride, and sealants. A child was considered to have a dental home if he or she had a comprehensive exam plus a periodic exam or 2 periodic exams, within 1 year. Results: 16.7% of children had a claim filed for at least 1 comprehensive exam, 59.6% for a periodic exam, 59.3% for a dental prophylaxis, 48.6% for fluoride, and 12.2% for sealants. After adjusting for differences in ages of children seen by the 2 provider types, pediatric dentists were 1.6 times more likely to file a claim for fluoride (p<0.001), and 1.3 times more likely to file a claim for sealants (p<0.001). There was no difference between specialists and generalists for the prophylaxis measure. 12.6% of children (1638/12964) had dental homes. Children seen by pediatric dentists were only slightly more likely to have a dental home (463/3291 children, 14.1%) than children seen by general dentists (1175/9673 children, 12.1%; OR=1.2, p<0.002). Having a dental home is associated with receiving preventive services. Conclusion: The quality of care for Medicaid-enrolled children fails to meet American Association of Pediatric Dentistry guidelines and improvements would help beneficiaries. The hypothesis of no difference in care quality provided by specialists and generalists to Medicaid-enrolled children is partially rejected. | ||
| Seq #170 - Dental Practice Patterns, Technology, and Quality Issues 3:00 PM-4:00 PM, Friday, 10 March 2006 Dolphin Hotel Pacific Hall | ||
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