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Rural–Urban Differences in Dental Service Utilization Among an Early Childhood Population Enrolled in South Carolina Medicaid

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Abstract

Our exploratory study examined rural–urban differences in dental care utilization during early childhood among Medicaid-enrolled children aged younger than 4 years in South Carolina. We conducted a secondary data analysis using Medicaid data. Dependent variables included preventive dental visits, use of medical settings (emergency room [ER] and primary care [PC] offices) for dental reasons, receipt of fluoride varnish, and dental home status. The primary independent variable was child’s area of residence, rural or urban. The control variables were child’s age, gender, race, and special healthcare need status. In adjusted analyses, rural children were found to have significantly higher odds of lacking preventive dental visits, fluoride varnishes, and dental homes as well as using medical settings for dental reasons compared to urban children. This difference, however, was not a simple function of rural residence. Other variables such as race and special healthcare need status interacted with rurality in explaining the differences in the outcomes of interest except visiting medical settings for dental reasons. Children under age of 2 years had higher odds of undesirable outcomes compared to those aged older than 2 years. Significant disparities in dental care utilization were evident among rural, Medicaid-enrolled preschool-aged children in South Carolina. While the state has addressed Medicaid reimbursement and related policies for nearly 10 years, their impact may be disproportionately effective.

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Acknowledgments

Our study was funded through a subcontract from SCDHEC to the South Carolina Rural Health Research Center. The funding source is the State Oral Health Infrastructure Cooperative Agreement awarded to SCDHEC by the Center for Disease Control and Prevention (CDC), #U58/DP001587. Its content are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

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Authors and Affiliations

  1. SC Rural Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC, 29210, USA

    Amy Brock Martin & Medha Vyavaharkar

  2. Oral Health Division, South Carolina Department of Health and Environmental Control, Columbia, SC, USA

    Christine Veschusio

  3. Office of Research and Statistics, South Carolina Budget and Control Board, Columbia, SC, USA

    Heather Kirby

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  1. Amy Brock Martin
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  2. Medha Vyavaharkar
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  3. Christine Veschusio
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  4. Heather Kirby
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Correspondence to Amy Brock Martin.

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Martin, A.B., Vyavaharkar, M., Veschusio, C. et al. Rural–Urban Differences in Dental Service Utilization Among an Early Childhood Population Enrolled in South Carolina Medicaid. Matern Child Health J 16, 203–211 (2012). https://doi.org/10.1007/s10995-010-0725-1

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