The Impact of a Home Visiting Program on Children’s Utilization of Dental Services

Author:

Brickhouse Tegwyn H.1,Haldiman Robin R.2,Evani Bhanu3

Affiliation:

1. Department of Pediatric Dentistry, Virginia Commonwealth University School of Dentistry, Richmond, Virginia;

2. Child Health Investment Partnership of Roanoke Valley, Roanoke, Virginia; and

3. Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Abstract

BACKGROUND: Child Health Investment Partnership (CHIP) of Roanoke Valley is a home visiting program that promotes children’s health and family self-sufficiency. CHIP’s Begin With a Grin program provides preventive dental services in the home (oral health anticipatory guidance and fluoride varnish) for children aged 0 to 6 years. The purpose of this study was to compare the dental utilization of Medicaid-enrolled children in CHIP versus Medicaid-enrolled children not in CHIP. METHODS: Using the propensity score method, control subjects were selected from the statewide Medicaid database by using a caliper-matching algorithm. A vector of chosen covariates was used to match control subjects; these covariates included risk factors, estimated propensity score, age, race, gender, and days of Medicaid eligibility. Propensity scores were developed by using a logistic regression. Differences in dental utilization outcomes were tested: ≥1 dental claim (logistic regression) and number of dental claims (Poisson regression) for each subject within the test period. RESULTS: When CHIP children were compared with Medicaid-only children, the CHIP child was 3 times more likely to have at least 1 dental visit (odds ratio: 3.0 [95% confidence interval: 1.9–4.7]) and have a higher number of dental claims (ratio of estimated average number of dental claims [cases/control]: 8.60/3.05 = 2.82 [95% confidence interval: 2.56–3.12]). CONCLUSIONS: A home visiting model can introduce children and their families to dental prevention, improve dental health literacy, establish a dental home, and provide application of fluoride varnish.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference20 articles.

1. Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994.;Vargas;J Am Dent Assoc,1998

2. Screening for low literacy among adult caregivers of pediatric patients.;Bennett;Fam Med,2003

3. Pew Center on the States. Joining HANDS for a comprehensive system of care. Available at: www.pewcenteronthestates.org/homevisiting. Accessed December 2012

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