Pardee RAND Graduate School, Santa Monica, CA, USA.
RAND Corporation, Arlington, VA, USA.
J Public Health Dent. 2018 Sep;78(4):337-345. doi: 10.1111/jphd.12278. Epub 2018 Aug 31.
To examine the association between type of health insurance (public, uninsured, private, or other) and oral health outcomes for children in the United States using nationally representative surveillance data.
Using the National Health and Nutrition Examination Survey (2011/12-2013/14), logistic regression models were used to estimate the odds of any dental caries and any untreated caries by type of health insurance (public, uninsured, private, and other) for children aged 2-19 years, with adjustment for relevant individual and socioeconomic characteristics.
Among 6,057 children, the odds of having any dental caries or untreated caries was not significantly different for publicly insured and uninsured children compared to privately insured children, when adjusting for family income and education. Children in families with income to poverty ratios <200 percent had greater odds of caries and untreated caries relative to children in families with income to poverty ratios ≥400 percent. Children with less educated parents also experienced greater odds of caries and untreated caries.
Oral health outcomes, after adjusting for covariates, were similar for children with public and private health insurance. However, children in low-income families and with less educated parents had greater odds of untreated caries and dental caries, suggesting that initiatives focused on publicly insured populations may miss other vulnerable children of low socioeconomic status.
利用全国代表性监测数据,研究美国儿童的医疗保险类型(公共、无保险、私人或其他)与口腔健康结果之间的关系。
使用全国健康和营养调查(2011/12-2013/14),使用逻辑回归模型,根据医疗保险类型(公共、无保险、私人和其他),调整相关个体和社会经济特征后,估计 2-19 岁儿童任何龋齿和未经治疗龋齿的几率。
在 6057 名儿童中,与私人保险儿童相比,公共保险和无保险儿童的任何龋齿或未经治疗龋齿的几率在调整家庭收入和教育后没有显著差异。收入与贫困比例<200%的家庭的儿童比收入与贫困比例≥400%的家庭的儿童更容易发生龋齿和未经治疗的龋齿。父母受教育程度较低的儿童也更容易发生龋齿和未经治疗的龋齿。
在调整了协变量后,接受公共和私人医疗保险的儿童的口腔健康结果相似。然而,低收入家庭和父母受教育程度较低的儿童未经治疗的龋齿和龋齿的几率更高,这表明专注于公共保险人群的举措可能会错过其他社会经济地位较低的弱势儿童。