Access to dental care pre and post enrollment in a State Children's Health Insurance Program (SCHIP)

Objective: To examine differences in access to dental care for new enrollees in a SCHIP compared to the same enrollees after 12 months in the program.

Methods: Families of newly enrolled children received mail surveys when the children were enrolled (return rate=64%; n=4,638) and after they were in the SCHIP for 12 months (return rate=61%; n=3,449). Only those who responded to both the new and continuous enrollee surveys were included in the sample (n=835). Responses to specific questions about dental care were matched for each respondent and analyzed for children 6-18 yr. (n=740) using chi-square and logistic regression procedures.

Results: Among respondents (mostly parents), 74% had family income < 150% FPL, 76% had at least a high school education, 54% lived in a metropolitan area, 53% of the children were male, 89% school-aged or adolescent, 55% were Caucasian, and 18% were reported to have a special need. Children's access improved from enrollment to 12 months later. Couldn't get needed care (51.1%-9.7%) and waited too long (52.8%-10.6%) were significantly related to age, race, urbanicity, and special needs. More than 2 yrs since last dental visit (32.3%-7%) was related to age and race only.

Conclusions: Children who enrolled in a SCHIP had improved access to dental care over their first 12 months of enrollment. By offering dental care to a group of children who might not previously had such care the SCHIP has the opportunity to reduce the rate of dental caries, especially for school aged children and children with special needs.