The Effect of Public Insurance on Dental Health Outcomes

公共保险对牙齿健康结果的影响

• 批准号: 6411912
• 负责人: TEGWYN H BRICKHOUSE
• 金额: $ 3.23万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2002-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6411912
• 关键词: Medicare /Medicaid; behavioral /social science research tag; clinical research; dental health insurance; dental health services; health care quality; health care service availability; health care service evaluation; health care service planning; health care service utilization; health services research tag; human data; low socioeconomic status; medically underserved population; oral health; outcomes research; preschool child (1-5); public assistance; public health

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.

许多障碍威胁着幼儿获得口腔保健服务。制定的有关口腔保健服务覆盖范围的政策并不一定意味着儿童能够获得这些服务。在公共资助的项目中，低水平的提供者参与和报销率是无法实现获得口腔健康服务的关键因素。此外，参加这些公共项目的儿童来自社会经济地位较低的家庭，在获得医疗保健方面往往面临多重障碍。北卡罗来纳州的SCHIP计划，或健康选择（NCHC）计划，通过北卡罗来纳州蓝十字/蓝盾的私人保险计划提供健康服务，包括牙科。另一个公共健康保险项目是州医疗补助计划。这项调查代表了深入比较儿童的牙齿健康状况和他们接受牙科服务，通过北卡医疗补助计划和北卡健康选择计划。这项分析将把1999年7月至2000年6月期间，1-5岁的儿童，在医疗补助计划或NCHC中登记，与他们的牙科索赔档案联系起来，创建牙科服务利用的个人层面数据。此外，1999-2000学年对幼儿园学龄儿童龋齿的NC监测将与程序索赔合并，为医疗补助和NCHC注册定义的具有代表性的幼儿样本创建关于临床状态和牙科服务使用的个人水平数据。调查的第一部分比较了1 - 5岁儿童在医疗补助和NCHC之间使用牙科服务的情况。调查的第二部分检查在两个保险计划之间的计划绩效的指定过程措施的差异。调查的第三部分比较了两种公立牙科项目幼儿园学龄儿童的牙齿健康状况和未治疗的牙病。该项目深入比较了牙科服务的使用情况、已建立的儿童口腔健康绩效指标的有效性，以及牙科服务、已建立的儿童口腔健康绩效指标的有效性，以及参加NC医疗补助计划或NCHC的儿童的牙齿健康状况。本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，当结构类似于私人保险时。