Preventive dental utilization for Medicaid‐enrolled children in Iowa identified with intellectual and/or developmental disability

Department of Pediatric Dentistry, The University of Iowa
Journal of Public Health Dentistry (Impact Factor: 1.64). 12/2009; 70(1):35 - 44. DOI: 10.1111/j.1752-7325.2009.00141.x

ABSTRACT Objectives: To compare preventive dental utilization for children with intellectual and/or developmental disability (IDD) and those without IDD and to identify factors associated with dental utilization.Methods: We analyzed Iowa Medicaid dental claims submitted during calendar year (CY) 2005 for a cohort of children ages 3-17 who were eligible for Medicaid for at least 11 months in CY 2005 (n = 107,605). A protocol for identifying IDD children was developed by a group of dentists and physicians with clinical experience in treating children with disabilities. Utilization rates were compared for the two groups. Crude and covariate-adjusted odds ratios were estimated using conditional logistic regression modeling.Results: A significantly higher proportion of non-IDD children received preventive care than those identified as IDD (48.6 percent versus 46.1 percent; P < 0.001). However, the final model revealed no statistically significant difference between the two groups. Factors such as older age, not residing in a dental Health Professional Shortage Area, interaction with the medical system, and family characteristics increased one's likelihood of receiving preventive dental care.Conclusion: Although IDD children face additional barriers to receiving dental care and may be at greater risk for dental disease, they utilize preventive dental services at the same rate as non-IDD children. Clinical and policy efforts should focus on ensuring that all Medicaid-enrolled children receive need-appropriate levels of preventive dental care.

Download full-text


Available from: Donald L. Chi, Oct 07, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: A general methodology to map computations carried out on two-dimensional systolic arrays onto one-dimensional arrays is developed. The basic idea of the technique is to map computations of two-dimensional systolic arrays onto one-dimensional arrays in such a way that they satisfy the dependencies in the original problem. Using the technique, the two-dimensional arrays that have been developed for a large class of problems can be translated into one-dimensional arrays with the designs which can be implemented in wafer-scale integration (WSI). Compared to known designs in the literature, the methodology is an improvement in that it leads to modular systolic arrays with contrast hardware in each processing element, few control lines, lexicographic data input/output format, and improved delay time
    Wafer Scale Integration, 1989. Proceedings., [1st] International Conference on; 02/1989
  • [Show abstract] [Hide abstract]
    ABSTRACT: A self-tuning expert fuzzy controller has been developed and applied in real time to a process control problem. As in other expert systems, the knowledge base consists of rules describing the control law in terms of the process error and the resulting control action. Conditions and conclusions of each rule are fuzzy variables which are described through their membership curves. The inference engine used is the backward chaining process of the Prolog language. To implement the self-tuning property, the membership curve of the controller output has been changed according to an error based performance index. A control supervisor makes this tuning decision as a function of past or predicted future set-point errors of the control system. To verify the viability of this fuzzy controller, it has been applied to control the speed of a DC motor and the angular position of an inverted pendulum. The paper also discusses the stability problems associated with this control scheme.
    American Control Conference, 1989; 07/1989
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess the impact of chronic condition (CC) status and CC severity, respectively, on the odds of receiving dental treatment under general anesthesia (GA) for Medicaid-enrolled children by age group.Methods: This was a retrospective analysis of Iowa Medicaid-enrolled children <15 years (n = 62 721) from 2005 to 2008. 3M Clinical Risk Grouping Software identified each child’s CC status (yes/no) and assigned children with a CC into a hierarchal CC severity group (episodic/life-long/complex). Multiple variable logistic regression models were used to identify the determinants of dental treatment under GA.Results: Less than 1% of children received dental treatment under GA. While there was no significant difference in dental treatment under GA by CC status for children <6, those with a life-long CC were twice as likely to receive dental treatment under GA as demographically similar children with an episodic CC (P < 0.05). Children ages 6–14 with a CC were three times as likely as those without a CC to receive treatment under GA (P = 0.001). There was also a direct relationship between CC severity and dental treatment under GA use for older children. Those living in nonmetropolitan areas were more likely to receive treatment under GA as were children who previously received dental treatment under GA.Conclusions: Chronic condition status and severity were more important determinants of dental treatment under GA for Medicaid-enrolled children ages 6–14 than for those <6. Understanding these relationships is a critical step in developing clinical strategies and interventions aimed at preventing dental disease for Medicaid-enrolled children whose reasons for needing dental treatment under GA are modifiable.
    Pediatric Anesthesia 08/2010; 20(9):856 - 865. DOI:10.1111/j.1460-9592.2010.03371.x · 1.74 Impact Factor
Show more