229244 Rural-urban differences in early childhood dental service utilization patterns among Medicaid-enrolled children in South Carolina

Monday, November 8, 2010

Medha V. Vyavaharkar, PhD, MPH, MD , South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina., Columbia, SC
Amy B. Martin, DrPH , Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
Purpose: This study examined rural-urban differences in dental care utilization during early childhood among Medicaid enrolled children aged younger than 4 years in South Carolina (SC). Methods: We conducted a secondary data analysis using Medicaid data stored by the Office of Research and Statistics of the SC State Budget and Control Board. Dependent variables included regular preventive dental visits, use of emergency room (ER) and primary care (PC) services for dental reasons, receipt of fluoride varnish, and dental home status. The primary independent variable was child's area of residence, rural or urban. The control variables included child's age, gender, race, special healthcare need status, and dental health professional shortage area designation. Results: In adjusted analyses, rural children were found to have significantly higher odds of lacking regular preventive dental visits, fluoride varnishes, and dental homes as well as using ER and PC services for dental reasons compared to urban children. However, for regular preventive dental visits, use of PC services for dental reasons, and receipt of fluoride varnish, the rural-urban difference was not a simple function of rural residence. Race and gender interacted with rurality in explaining the differences in these outcomes. Conclusion: Rural Medicaid-enrolled pre-school children continue to have significant disparities in dental care utilization during early childhood compared to urban children living in SC. Focused efforts and targeted interventions are needed to address these disparities and to ensure availability of and access to dental care services for young children in rural areas.

Learning Areas:
Public health or related education

Learning Objectives:
At the end of the session, the participants will be able to - 1) Identify significant predictors of regular preventive dental visits, receipt of fluoride varnish, dental home status, and use of emergency room and primary care services for dental reasons during early childhood among Medicaid-enrolled children living in South Carolina 2) List at least 3 early childhood dental service utilization-related measures which indicate significant disparities among Medicaid-enrolled rural and urban children living in South Carolina 3) Discuss implications of rural-urban disparities in early childhood dental service utilization patterns among Medicaid-enrolled children living in South Carolina

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the P.I. on this study and supervised data analysis, interpretation of results, presentation of the findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.