Online Program

Ethnic disparities in Medicaid dental utilization in San Francisco

Monday, November 4, 2013

Muhammad Mughni, BDS, MPH, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, CA
Howard F. Pollick, BDS, MPH, School of Dentistry, University of California San Francisco, San Francisco, CA
Robert Isman, DDS, MPH, Medi-Cal Dental Services Branch, California Department of Health Services, Sacramento, CA
Jodi Stookey, PhD, Maternal, Child & Adolescent Health, San Francisco Department of Public Health, San Francisco, CA
Ann Lazar, PhD, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, CA
Objective: To inform tailored oral health interventions, this panel study aimed to analyze dental utilization rates among children in San Francisco enrolled in California's fee for service Medicaid dental program (“Denti-Cal”), by ethnicity and age, and to identify ethnic and/or age groups with disproportionately low utilization. Methods: Data, reported by the California Department of Health Care Services for children with residence in San Francisco and eligible for Denti-Cal services during FY2003-2012, were used to determine the number and proportion of eligible children and youth utilizing Denti-Cal by race/ethnicity (136,703 out of 322,313 eligible, ages 0-20). Mixed models were used to test for significant between-group differences in the utilization rates and trends by age. Results: Between 2003 and 2012, there was an overall increase of 18.8% in the Denti-Cal utilization rate among children ages 0-20. However, there were greater increases among children ages 0-8 than ages 9-20 (53.1% vs. 2.7%) respectively. Chinese (35.1%) and Hispanic (41.6%) children were the only ethnic groups with significant increases over this period. Furthermore, there was an overall significant increase among children ages 0-20 (22.3%) from 2008-2012 vs. (0.7%) from 2003-2007. There was a particularly significant increase (107.7%) in the use of Denti-Cal services among children 0-3 years in the last 5 years. Conclusions: Based on preliminary analysis, there were significant increases in Denti-Cal utilization rate among children 0-3 years, and among Chinese and Hispanic ethnic groups. However, disparities still exist among other ethnic and/or age groups, even with access to free dental services through Medicaid.

Learning Areas:

Diversity and culture
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe the Medicaid dental utilization rate stratified according to ethnicity and age. Compare secular trends over time. Discuss the focus intervention areas.

Keyword(s): Oral Health, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a foreign trained dentist with training in clinical dentistry and epidemiology. After completing my Masters in Public Health at University of Oklahoma, I pursued a Fellowship in Dental Public Health at Case Western Reserve University, Cleveland, Ohio. I am presently pursuing a residency in Dental Public Health at the University of California, San Francisco. I have also worked as an epidemiologist at California Department of Public Health.
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.