Journal article
Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents
Journal of Public Health Dentistry, Vol.73(1), pp.56-64
01/01/2013
DOI: 10.1111/jphd.12006
PMCID: PMC4114349
PMID: 23289856
Abstract
To describe rates of Medicaid-funded services provided by orthodontists in Iowa to children and adolescents, identify factors associated with utilization, and describe geographic barriers to care. We analyzed enrollment and claims data from the Iowa Medicaid program for a 3-year period, January 2008 through December 2010. Descriptive, bivariate, and multivariable logistic regression analyses were performed with utilization of orthodontic services as the main outcome variable. Service areas were identified by small area analysis in order to examine regional variability in utilization. The overall rate of orthodontic utilization was 3.1 percent. Medicaid enrollees living in small towns and rural areas were more likely to utilize orthodontic services than those living in urban areas. Children who had an oral evaluation by a primary care provider in the year prior to the study period were more likely to receive orthodontic services. Service areas with lower population density and greater mean travel distance to participating orthodontists had higher utilization rates than smaller, more densely populated areas. Rural residency and increased travel distances do not appear to act as barriers to orthodontic care for this population. The wide variability of utilization rates seen across service areas may be related to workforce supply in the form of orthodontists who accept Medicaid-insured patients. Referrals to orthodontists from primary care dentists may improve access to specialty care for Medicaid enrollees.
Details
- Title: Subtitle
- Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents
- Creators
- Susan C McKernan - University of Iowa, Preventive and Community DentistryRaymond A Kuthy - University of Iowa, Center for Social Science InnovationElizabeth T Momany - University of Iowa, Center for Social Science InnovationMichelle R McQuistan - University of Iowa, Preventive and Community DentistryPaul F Hanley - University of Iowa, Civil and Environmental EngineeringMichael P Jones - University of Iowa, Statistics and Actuarial SciencePeter C Damiano - University of Iowa, Preventive and Community Dentistry
- Resource Type
- Journal article
- Publication Details
- Journal of Public Health Dentistry, Vol.73(1), pp.56-64
- DOI
- 10.1111/jphd.12006
- PMID
- 23289856
- PMCID
- PMC4114349
- NLM abbreviation
- J Public Health Dent
- ISSN
- 0022-4006
- eISSN
- 1752-7325
- Publisher
- Wiley Subscription Services, Inc
- Language
- English
- Date published
- 01/01/2013
- Description audience
- Academic
- Academic Unit
- Preventive and Community Dentistry; Public Policy Center (Archive); Oral Health Policy Research
- Record Identifier
- 9983756998002771
Metrics
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