Effects of WIC on Child Medicaid Dental Use and Costs
Funded Grant
Overview
Overview
description
DESCRIPTION (provided by applicant): The purpose of this research project is to examine the relationship of the Women, Infants and Children?s Supplemental Food Program (WIC) on oral health utilization patterns and cost to the Medicaid program by children under five years of age. The current level of oral health service utilization in Medicaid had presented a major public policy challenge as evident by reports from the Office of Technology Assessment, the General Accounting Office, and the Office of the Surgeon General. This investigation will examine the role of a partnership between Medicaid with another federal program, WIC, and its effects on Medicaid utilization and expenditures. The candidate will use five large databases: Composite birth records from 1992; Medicaid enrollment and claims files from 1992-97; WIC masterfiles from 1992-97; and the Area Resource File. This retrospective longitudinal cohort study treats the child as the unit of analysis. The data set will contain multiple observations per child-that is one observation for each year until the fifth birthday. Panel data techniques, random effects models, will be incorporated into the estimation equations. While controlling for predisposing and enabling characteristics, the candidate will examine the role of WIC participation on five different outcome measures: The first, any oral health utilization, will be defined as any Medicaid claim filed for a dental visit. The second, extent of utilization, will be defined by the number of Medicaid dental visits. The third, type of visit, would include preventive, restorative and emergency visits as defined by American Dental Association procedure codes. The fourth, avoidable hospitalizations, is defined by "hospital care" with the ICD-9 code of 521.0, dental caries. The fifth is dental related Medicaid expenditures as measured by actual paid Medicaid claims. Because of the non-randomized nature of the study, there is the potential that selection bias could be present. The candidate will employ instrumental techniques and the proper specification tests to account for the selection bias that is present. This proposed study will explore an entirely new aspect of Medicaid utilization, the role of WIC and its partnership to help increase oral health access for young Medicaid children.
