Edelstein Burton L, Manski Richard J, Moeller John E
Division of Community Health, Columbia University, School of Dental and Oral Surgery, and Children's Dental Health Project of Washington, DC, USA.
Pediatr Dent. 2002 Jan-Feb;24(1):11-7.
Because little has been reported about child dental expenditures, federal data were used to estimate dental care expenditures for U.S. children by age, sex, ethnic/ racial background, family income, parental education and parental employment.
Parentally reported data on dental expenditures and sources of expenditures were extracted from the most recent available federal healthcare expenditures studies, the 1996 federal Medical Expenditure Panel Survey (MEPS). Using the survey's large sample and complex design, these data represent the entire U.S. child population.
Nearly 12 billion dollars were expended for children's dental care averaging $375 per child who obtained care. Overall sources of payment were 47% out of pocket, 45% insurance and 8% "other" including primarily Medicaid. Disproportionately litde spending was made on behalf of low-income and minority children despite their higher disease experience. The proportion of spending that was paid out of pocket was high for all groups of children including those eligible for Medicaid even though Medicaid prohibits cost sharing.
Dental care for children accounts for approximately one-quarter of U.S. dental spending and is a major component of child health care costs. Income and racial disparities in expenditures favor higher income children despite Medicaid coverage for lower income children. High levels of reported out-of-pocket costs for Medicaid eligible children suggest that Medicaid fails to meet families' needs in obtaining care. Meeting the oral health needs of poor children will require considerably greater expenditures, particularly through improved Medicaid financing and administration.
由于关于儿童牙科支出的报道较少，因此利用联邦数据按年龄、性别、种族/民族背景、家庭收入、父母教育程度和父母就业情况来估算美国儿童的牙科护理支出。
从最新可得的联邦医疗保健支出研究，即1996年联邦医疗支出小组调查（MEPS）中提取父母报告的牙科支出及支出来源数据。利用该调查的大样本和复杂设计，这些数据代表了整个美国儿童人口。
儿童牙科护理支出近120亿美元，获得护理的儿童平均每人375美元。总体支付来源为：47%自掏腰包，45%为保险支付，8%为“其他”，主要包括医疗补助。尽管低收入和少数族裔儿童患病情况更严重，但为他们支出的费用却不成比例地少。所有儿童群体，包括符合医疗补助条件的儿童，自掏腰包支出的比例都很高，尽管医疗补助禁止费用分摊。
儿童牙科护理约占美国牙科支出的四分之一，是儿童医疗保健成本的一个主要组成部分。尽管低收入儿童有医疗补助覆盖，但支出方面的收入和种族差异却有利于高收入儿童。符合医疗补助条件的儿童自掏腰包费用报告水平较高，这表明医疗补助未能满足家庭获得护理的需求。满足贫困儿童的口腔健康需求将需要大幅增加支出，特别是通过改善医疗补助的融资和管理。
