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。 关于口腔保健服务覆盖范围的已颁布政策并不一定转化为儿童实际享有的服务。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，提供医疗服务，包括牙科通过北卡罗来纳州蓝十字/蓝盾的私人保险计划。 另一个公共医疗保险计划是州医疗补助计划。 这项调查代表了深入比较儿童的牙齿健康状况和他们通过NC医疗补助计划与NC健康选择计划接受牙科服务。 这项分析将把1999年7月至2000年6月期间参加医疗补助或NCHC的1 - 5岁儿童与他们的牙科索赔档案联系起来，建立关于牙科服务利用情况的个人数据。 此外，1999 - 2000学年对幼儿园年龄儿童龋齿的NC监测将与程序索赔合并，为医疗补助和NCHC登记定义的幼儿代表性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医疗补助和NCHC之间1至5岁儿童牙科服务的使用。 调查的第二部分探讨了两个保险计划之间的计划绩效的具体过程措施的差异。 调查的第三部分比较了幼儿园年龄儿童的牙齿健康状况和未经治疗的牙科疾病，无论是在公共牙科计划。 该项目代表了一个深入的比较牙科服务的利用率，有效性的既定儿科口腔健康绩效指标，牙科服务，有效性的既定儿科口腔健康绩效指标，以及牙齿健康状况的儿童参加无论是在NC医疗补助计划或NCHC。这项研究提供了一个机会，以确定低收入儿童的公共牙科保险的好处时，结构类似于私人保险。

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.