Provision of fluoride varnish treatment by medical and dental care providers: variation by race/ethnicity and levels of urban influence. J Public Health Dent 2010;70(3):211-9
Date
05/13/2010Pubmed ID
20459463Pubmed Central ID
PMC2967666DOI
10.1111/j.1752-7325.2010.00168.xScopus ID
2-s2.0-77956309935 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
OBJECTIVE: In 2004, Wisconsin Medicaid policy changed to allow medical care providers to be reimbursed for fluoride varnish treatment (FVT) to children's teeth to improve access and utilization. To date, no study has been published on whether geographic and racial/ethnic variation in the provision of FVT in response to this policy change exists. This study's objective is to examine the association of rates of FVT for children enrolled in Wisconsin Medicaid with race/ethnicity, urban influence codes (UIC), and dental health professional shortage area (DHPSA) designation based on county of residence.
METHODS: A retrospective, pre-post design was used based on FVT claims for children in the Wisconsin Medicaid program from 2002 to 2006. Poisson regression models were used to evaluate the association of rates of FVT claims with race/ ethnicity, UIC, and DHPSA designation.
RESULTS: The rate of FVT claims varied by resident county-type according to UIC and DHPSA designation, age, and race/ethnicity. Post-policy, the largest increases were observed for Native Americans residing in non-DHPSA counties, enrollees living in rural counties, and for Hispanics living in partial and entire DHPSA counties. African-Americans residing in partial DHPSA and metropolitan counties displayed the lowest rates of FVT claims.
CONCLUSIONS: Overall access and utilization of FVT increased, but substantial racial/ ethnic and geographic variation in the provision of FVT for children enrolled in Wisconsin Medicaid was observed. Future policies should incorporate measures that will specifically address the racial and geographic variations identified in this study.
Author List
Okunseri C, Szabo A, Garcia RI, Jackson S, Pajewski NMAuthors
Christopher Okunseri DDS,MS Associate Professor and Director in the Clinical Services department at Marquette UniversityAniko Szabo PhD Professor in the Data Science Institute department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Age FactorsChild
Child, Preschool
Dentists
Fee-for-Service Plans
Fluorides, Topical
Health Policy
Health Services Accessibility
Humans
Indians, North American
Infant
Managed Care Programs
Medicaid
Medically Underserved Area
Residence Characteristics
Retrospective Studies
Rural Population
United States
Urban Population
Wisconsin