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County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: how does
1Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195, USA. dchi@uw.edu
Abstract:
Little is known about how place affects childrens' access to dental care. We analyzed data for 25,908 Iowa Medicaid-enrolled children with chronic conditions to identify the county-level determinants of dental utilization. Our analyses suggest that higher levels of poverty and designation as a dental health professional shortage area at the county-level are associated with lower probability of child-level dental use. There are significant interactions between child-level race/ethnicity and county-level poverty as well as between child-level disability and county-level unemployment. We present a new descriptive model on dental utilization that emphasizes county-level factors as well as interactions between county-level and child-level factors.
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