Do More Generous Medicaid Benefits for Adults Result in Higher Dental Utilization and Tooth Retention?

Open Access
Author:
Ventura, Marta Jaen
Graduate Program:
Industrial Engineering
Degree:
Master of Science
Document Type:
Master Thesis
Date of Defense:
None
Committee Members:
  • Dr Paul Griffin, Thesis Advisor
  • Dr Susan Griffin, Thesis Advisor
Keywords:
  • logistic regression
  • tooth retention
  • dental utilization
  • Medicaid dental benefits
Abstract:
The two objectives in this study are to examine the association between 1) Medicaid dental benefits (MDB) and dental utilization (past-year dental visit) in 2010 and 2) MDB for 2 years (2002 and 2010) and tooth retention (complete retention, functional dentition, and not having functional dentition). For the first model, the analysis uses data on MDB from 2010 from the American Dental Association (ADA) and merges it with Behavioral Risk Factor Surveillance System data (BRFSS) for 50 states and the District of Columbia. For the second model, the analysis uses data on MDB from 2002 and the historical average from 2003 to 2009 (for 2010) from the ADA and merges it with BRFSS data for 50 states and the District of Columbia for 2002 and 2010. Adults are classified as low-income (<100% of FPL) or high-income (>340% of FPL). Logistic regression models are used to estimate the probabilities of both dental utilization and tooth retention. Explanatory variables in both models include the main effect variables (income and MDB) and potential confounders (age, sex, educational attainment, race/ethnicity, general health status, and smoking status). The utilization regression also included edentulous status and a term for interaction between MDB and income. A significant and positive interaction term would suggest that MDP has a greater effect on dental utilization among low-income than among high-income adults. The retention regression included state and year effects; 2 way interaction terms for MDP and income, year and MDP, and year and income; and a 3 way interaction term for MDP, income, and year. Higher-income adults serve as controls in both models. Results from the dental utilization model indicate that increasing MDB coverage from not comprehensive to comprehensive is associated with a higher increase in dental utilization among low-income adults than among high-income adults. Results for the tooth retention model indicate that the effect of MDP on increased tooth retention over time is higher for low-income adults than for high-income adults.