Department of Pediatric Dentistry, Public Policy Center, University of Iowa, Iowa City, USA.
Am J Public Health. 2011 May;101(5):922-9. doi: 10.2105/AJPH.2010.191940. Epub 2010 Nov 18.
We evaluated the relationship between having an intellectual or developmental disability (IDD) and the timing of the first dental visit for children who were newly enrolled in Medicaid in Iowa.
We identified children aged 3 to 8 years with and without IDD who were newly enrolled in the Iowa Medicaid program in 2005 (N = 5391). We gathered data on presence of IDD, health status, age at baseline, gender, length of Medicaid enrollment, medical care visits, household Medicaid enrollment, urbanization, residence in a federally designated Health Professional Shortage Area (HPSA), and time of first dental visit through 2007.
About 32% of children had a first dental visit within 6 months of enrollment; this proportion increased to 49%, 64%, and 74% by years 1, 2, and 3, respectively. In the unadjusted models, there was no significant difference between children with and without IDD in time to first dental visit (P = .22). After adjusting for model covariates, however, children with IDD were 31% more likely to have a delayed first dental visit (P = .04).
Newly Medicaid-enrolled children aged 3 to 8 years with IDD in Iowa were significantly more likely to have a later first dental visit. Future interventions should focus on ensuring timely access to first dental visits for all Medicaid-enrolled children, with an emphasis on those with IDD.
我们评估了在爱荷华州新加入医疗补助计划(Medicaid)的儿童中,智力或发育障碍(IDD)与首次看牙时间的关系。
我们确定了 2005 年新加入爱荷华州医疗补助计划的年龄在 3 至 8 岁之间的有和无 IDD 的儿童(N=5391)。我们收集了有关 IDD 存在情况、健康状况、基线年龄、性别、医疗补助计划参与时间、医疗保健就诊次数、家庭医疗补助计划参与情况、城市化程度、居住在联邦指定的卫生专业人员短缺地区(HPSA)以及首次看牙时间的数据,截至 2007 年。
约 32%的儿童在入组后 6 个月内进行了首次看牙;这一比例分别在第 1、2 和 3 年增加到 49%、64%和 74%。在未调整模型中,有和无 IDD 的儿童首次看牙时间没有显著差异(P=.22)。然而,在调整了模型协变量后,患有 IDD 的儿童首次看牙时间延迟的可能性增加了 31%(P=.04)。
爱荷华州新加入医疗补助计划的 3 至 8 岁的 IDD 儿童首次看牙的时间明显较晚。未来的干预措施应重点关注所有医疗补助计划参与者,尤其是那些有 IDD 的儿童,确保他们能够及时进行首次看牙。