The Effect of Public Insurance on Dental Health Outcomes

许多障碍威胁着幼儿获得口腔保健服务的机会。颁布的关于口腔保健服务覆盖面的政策不一定转化为实现儿童获得服务的机会。在公共资助的项目中，提供者的低参与率和报销率低是未能实现获得口腔健康服务的关键因素。此外，参加这些公共方案的儿童来自较低的社会经济家庭，在获得医疗保健方面往往面临多重障碍。北卡罗来纳州的芯片计划或健康选择(NCHC)计划提供医疗服务，包括通过北卡罗来纳州蓝十字/蓝盾的私人保险计划提供牙科服务。另一项公共医疗保险计划是州医疗补助计划。这项调查对儿童的牙齿健康状况以及他们通过NC医疗补助计划和NC健康选择计划获得的牙科服务进行了深入的比较。这项分析将把参加医疗补助或NCHC的1-5岁儿童与他们从1999年7月到2000年6月的牙科索赔文件联系起来，创建关于牙科服务利用情况的个人级数据。此外，1999-2000学年对幼儿园适龄儿童龋齿的NC监测将与程序索赔合并，为医疗补助和NCHC登记确定的具有代表性的幼儿样本创建关于临床状况和牙科服务使用情况的个人数据。调查的第一部分比较了医疗补助和NCHC对1至5岁儿童的牙科服务使用情况。调查的第二部分考察了两个保险计划在计划绩效的特定过程测量方面的差异。调查的第三部分比较了参加这两个公共牙科项目的幼儿园年龄儿童的牙齿健康状况和未经治疗的牙病。该项目对参加NC Medicaid计划或NCHC的儿童的牙科服务利用率、已建立的儿科口腔健康绩效指标的有效性、牙科服务、已建立的儿科口腔健康绩效指标的有效性以及牙科健康状况进行了深入的比较。这项研究提供了一个机会来确定公共牙科保险对低收入儿童的好处，当其结构类似于私人保险时。

Numerous barriers threaten access to oral health services for young children. Enacted policies regarding the coverage of oral health services do not necessarily translate into realized access for children. Low levels of provider participation and reimbursement rates in publicly funded programs are key factors in this unrealized access to oral health services. In addition, children enrolled in these public programs are from lower socioeconomic families and tend to face multiple barriers to accessing health care. North Carolina's SCHIP program, or Health Choice (NCHC) program, provides health services, including dental through NC Blue Cross/ Blue Shield's private insurance program. The other public health insurance program is the state Medicaid program. This investigation represents an in-depth comparison of children's dental health status and their receipt of dental services through the NC Medicaid Program versus the NC Health Choice Program. This analysis will link children, ages 1-5, enrolled in Medicaid or NCHC to their dental claims file from July 1999 through June 2000, creating person-level data on the utilization of dental services. In addition the NC surveillance of dental caries in Kindergarten aged children for the 1999-2000 school year will be merged with procedure claims creating person-level data on clinical status and use of dental services for a representative sample of young children who were defined by Medicaid and NCHC enrollment. The first part of the investigation compares the use of dental services between Medicaid and NCHC for children 1 to 5 years of age. The second part of the investigation examines differences in specified process measures of plan performance between the two insurance programs. The third part of the investigation compares the dental health status and untreated dental disease of kindergarten aged children enrolled in either public dental program. This project represents an in-depth comparison of the utilization of dental services, effectiveness of established pediatric oral health performance measures, and dental services, effectiveness of established pediatric oral health performance measures, and dental health status for children enrolled in either the NC Medicaid program or NCHC. This study provides an opportunity to determine the benefits of public dental insurance for low income children when structured similar to private insurance.