RAND Corporation, Arlington, Virginia.
RAND Corporation, Boston, Massachusetts.
Health Serv Res. 2019 Apr;54(2):437-445. doi: 10.1111/1475-6773.13093. Epub 2018 Nov 22.
To determine the impact of the inclusion of pediatric dental care in the Affordable Care Act's (ACA) core package of essential health benefits on dental coverage and utilization.
Children aged 1-18 years included in the nationally representative 2010-2015 National Health Interview Survey (NHIS).
We used regression-adjusted difference-in-differences to examine changes in rates of dental coverage and visits pre- and post-ACA for children likely to be affected by the ACA (have a parent working for a small employer) to a comparison group of children who were unlikely to be affected (have a parent in a firm with ≥50 employees). Models adjusted for relevant health and sociodemographic measures.
NHIS is an annual household survey conducted by the National Center for Health Statistics.
Comparing pre- and post-ACA periods, private dental insurance increased by 4.6 percentage points more (P = 0.013) and annual dental visits were unchanged (2.7 percentage points, P = 0.071) among children likely to be affected by the ACA compared to children unlikely to be affected by the ACA.
Inclusion of pediatric dental care as an ACA essential health benefit increased dental insurance coverage, but not dental visits among children likely to be affected by this policy.
确定《平价医疗法案》（ACA）核心基本健康福利包中纳入儿科牙科护理对牙科覆盖和利用的影响。
全国代表性的 2010-2015 年全国健康访谈调查（NHIS）中 1-18 岁的儿童。
我们使用回归调整的差异中的差异来检查 ACA 可能影响的儿童（有父母为小雇主工作）的牙科覆盖和就诊率在 ACA 前后的变化，以及不太可能受到影响的儿童（父母在员工人数≥50 的公司工作）的比较组。模型调整了相关健康和社会人口学措施。
NHIS 是由国家卫生统计中心进行的年度家庭调查。
与 ACA 前后时期相比，受 ACA 影响的儿童的私人牙科保险增加了 4.6 个百分点（P=0.013），而不太可能受 ACA 影响的儿童的年度牙科就诊次数不变（2.7 个百分点，P=0.071）。
将儿科牙科护理纳入 ACA 基本健康福利增加了受该政策影响的儿童的牙科保险覆盖范围，但并未增加他们的牙科就诊次数。
