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

Objective: To examine differences in preenrollment access to dental care in a SCHIP compared to access after 12 months in the program over a three year period.

Methods: Surveys were mailed to families of newly enrolled children and again after they were in the SCHIP for 12 months. Continuous enrollees newly enrolled the previous year were included in this analysis. Children under 6 were excluded. Responses to three questions about dental care were cross-tabulated with demographic characteristics and special health need status. Chi-square statistics were used to determine group differences. These were calculated separately for new enrollees and continuous enrollees and the significance levels for each time period were compared.

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Results: SCHIP improved access to care and helped reduce disparities among age groups, racial groups and special needs children. For age and race, significant pre-CHIP differences were dramatically reduced, e.g., the difference between ages 13-18 and 6-12 was reduced from p <.001 to p = .25. For special needs, significance levels were reduced but not as dramatically, e.g., p < .001 to < .01. These differences were consistent across the three indicators and across the three years.

Conclusions: Children enrolled in a SCHIP had improved access to dental care over their first 12 months of enrollment. Groups with less access improved more, thus reducing pre-CHIP disparities. By offering dental care especially to previously underserved children, SCHIP has the opportunity to improve oral health, especially for school aged children and children with special needs.