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。 已颁布的有关口腔保健服务覆盖范围的政策并不一定能转化为儿童实际获得的服务。公共资助项目的提供者参与度和报销率低是未能实现口腔保健服务的关键因素。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 NC Blue Cross/Blue Shield 的私人保险计划提供医疗服务，包括牙科服务。 另一个公共健康保险计划是州医疗补助计划。 这项调查深入比较了儿童的牙齿健康状况以及他们通过北卡罗来纳州医疗补助计划与北卡罗来纳州健康选择计划获得的牙科服务。 该分析将把参加 Medicaid 或 NCHC 的 1-5 岁儿童与其 1999 年 7 月至 2000 年 6 月期间的牙科索赔文件联系起来，创建有关牙科服务利用情况的个人数据。 此外，NC 对 1999-2000 学年幼儿园儿童龋齿的监测将与程序索赔合并，为由医疗补助和 NCHC 登记定义的幼儿代表性样本创建临床状态和牙科服务使用情况的个人数据。调查的第一部分比较了 Medicaid 和 NCHC 之间针对 1 至 5 岁儿童的牙科服务使用情况。 调查的第二部分检查了两个保险计划之间计划绩效的特定流程衡量标准的差异。 调查的第三部分比较了参加任一公共牙科计划的幼儿园儿童的牙齿健康状况和未经治疗的牙科疾病。 该项目深入比较了牙科服务的利用情况、既定儿科口腔健康绩效衡量标准的有效性，以及参加北卡罗来纳州医疗补助计划或 NCHC 的儿童的牙科服务、既定儿科口腔健康绩效衡量标准的有效性以及牙齿健康状况。这项研究提供了一个机会来确定公共牙科保险在结构类似于私人保险时对低收入儿童的好处。

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.