Does a new Children's Health Insurance Program (CHIP) improve access to dental care for children?

Objectives: Access to dental care for low-income children is limited. The North Carolina Health Choice for Children (NCHC) is a new health insurance program that affords poor families to access dental care for their children. This study examined the effect of NCHC on children's access to dental care. Methods: A pretest-posttest design with a posttest comparison group. The study population consisted of parents of a stratified, random sample of 639 children, ages 6 to 18. Parents responded to mailed survey questions about their child's access to dental services prior to enrolling and after one year of enrollment in NCHC. Outcome variables were use of dental services, perceived unmet dental need, and access to a usual source of dental care. Changes in outcome variables were examined in two age groups: 6-11 and 12-18. Two-tailed McNemar tests were used to detect statistically significant changes within-subjects. Results: Visit to a dentist in the previous year increased for ages 6-11 from 51% at baseline to 67% after one-year enrollment in NCHC while for ages 12-18 it increased from 42% to 61%. Unmet dental need decreased for ages 6-11 from 43% at baseline to 18% after enrollment in NCHC, and decreased for ages 12-18 from 42% to 19%. In addition, the proportion of children whose parents reported their child had a usual source of dental care significantly increased after enrollment in NCHC. Comparison group had similar levels of dental visits, perceived unmet need and usual source of dental care as the study population at baseline, thus ruling out secular trends. Results were significant at p<.05. Conclusion: The new children's health insurance program in North Carolina has made a significant impact on children's access to dental care. NCHC can be used as a model by other states that seek to improve dental access for low-income children.