Park S, Momany E T, Jones M P, Kuthy R A, Askelson N M, Wehby G L, Damiano P C, Chi D L
University of Washington, Seattle, WA, USA.
University of Iowa, Iowa City, IA, USA.
JDR Clin Trans Res. 2018 Jan;3(1):91-100. doi: 10.1177/2380084417728237. Epub 2017 Aug 23.
The objective of the study was to assess the effects of medical well baby visits in promoting earlier first dental visits. We analyzed Iowa Medicaid claims data (2000-2013). The sample included 4 cohorts of children born in 2000, 2003, 2007, or 2010 and enrolled in Medicaid from birth ( = 38,211). Children were followed for 3 y. The independent variables were cohort year and medical well baby visit frequency during 3 time periods (birth to age 10 mo, ages 11-19 mo, ages 20-36 mo). We used survival analyses to estimate first dental visit rates. First dental visit rates improved significantly from 2000 to 2013, with children in latter cohorts having significantly earlier first dental visits. Children with more medical well baby visits before age 11 mo had significantly delayed first dental visit rates than children with fewer medical well baby visits. The opposite was observed for children with more medical well baby visits between ages 11 to 19 mo and ages 20 to 36 mo. First dental visit rates for Medicaid-enrolled children have improved, but there continues to be a need for early interventions to improve age 1 dental visits and other preventive oral health behaviors. The results of this study can be used by policy makers when developing strategies to improve access to dental care for young children in Medicaid. With consideration to promoting earlier preventive dental visits for publicly insured children, this study could lead to early interventions and improved health outcomes.
该研究的目的是评估健康婴儿体检对促进首次看牙时间提前的影响。我们分析了爱荷华州医疗补助索赔数据(2000 - 2013年)。样本包括2000年、2003年、2007年或2010年出生且从出生就加入医疗补助计划的4组儿童(n = 38,211)。对儿童进行了3年的随访。自变量为队列年份以及三个时间段(出生至10个月、11 - 19个月、20 - 36个月)内的健康婴儿体检频率。我们使用生存分析来估计首次看牙率。从2000年到2013年,首次看牙率显著提高,后几个队列中的儿童首次看牙时间明显更早。11个月前接受更多健康婴儿体检的儿童首次看牙率比接受体检较少的儿童显著延迟。而对于11至19个月以及20至36个月期间接受更多健康婴儿体检的儿童则观察到相反的情况。参加医疗补助计划儿童的首次看牙率有所提高,但仍需要早期干预来改善1岁时的看牙情况及其他预防性口腔健康行为。政策制定者在制定改善医疗补助计划中幼儿获得牙科护理机会的策略时可使用本研究结果。考虑到促进公共保险儿童更早进行预防性看牙,本研究可能会带来早期干预并改善健康结果。