September 2006

PURPOSE

To describe dental care utilization by children enrolled in HUSKY A in 2005, to describe utilization trends, and to identify factors that suggest differential access to care.

METHODS

This report is the ninth annual summary of dental care utilization in HUSKY A (Medicaid managed care). Using HUSKY A enrollment data from the Connecticut Department of Social Services (DSS), children ages 3 to 19 years who were continuously enrolled between January 1 and December 31, 2005 were identified. Encounter data were searched for records corresponding to dental care services that these children received during that year. Utilization rates were calculated by comparing the number of continuously enrolled children who received at least one dental service to the total number of children who were continuously enrolled that year.

RESULTS

There were 146,046 children ages 3 to 19 years continuously enrolled in HUSKY A in 2005. Overall, just 48 percent of children 3 to 19 had any dental care in 2005, unchanged from the previous year.

Forty-one percent of children received at least one preventive dental care service in 2005, essentially unchanged from the previous year. After a steady increase in preventive care from 2000 to 2003, utilization has reached a plateau (Figure 1). Just 35 percent of children who had any preventive care received two or more preventive dental care services, as recommended by dental care professionals and required under EPSDT in Connecticut.

Twenty-two percent of children received dental treatment services in 2005, essentially unchanged from the previous year. Forty-five percent of children who had any treatment had two or more visits for treatment.

Five factors were associated with the utilization of preventive dental care services in 2005: age, race/ ethnicity, primary language, residence, and managed care plan. Preventive dental care rates were significantly higher for school-aged children 6 to 11 compared with younger or older children; for Hispanic children compared with White children or African American children and for children in Spanish speaking families. Elementary and middle school-aged children living in Hartford had the highest preventive care rates of all (Figure 2). Both preventive care and treatment rates increased significantly in New Haven in 2005 compared with 2004. Children enrolled in Community Health Network had the highest utilization rates.

CONCLUSIONS

• Less than half of children who are eligible for preventive dental care services through HUSKY A actually received these required services in 2005. 
  
• While dental care utilization has increased since the early years of the HUSKY Program, rates have not increased in recent years.
  
• Children in Hartford continue to receive dental care at rates far higher than other children in HUSKY A, largely due to availability of care from safety net providers in school-based and community clinics.

Full copies of the report are available at http://www.ctkidslink.org/pub_detail_316.html

About Connecticut Oral Health Initiative

The Connecticut Oral Health Initiative, or COHI for short, is a state-wide collaborative of dental professionals, business and community leaders. Our Mission is Oral Health Care for All. We work to persuade, educate and inform decision makers and the general public about the important issues involving oral health. We started in 1992 as a project of the Connecticut State Dental Association and incorporated as a separate 501(c)(3) non-profit corporation in 2003. We are supported by your tax-deductible contribution and grants from progressive foundations and businesses.