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Am J Orthod Dentofacial Orthop. Author manuscript; available in PMC 2017 April 01. Published in final edited form as: Am J Orthod Dentofacial Orthop. 2016 April ; 149(4): 516–522. doi:10.1016/j.ajodo.2015.09.025.
Racial Disparities in Orthodontic Service Utilization for Medicaid-Enrolled Children: An Evaluation of the Washington Medicaid Program
Author Manuscript
Jantraveus M. Merritt, DMD, MSDa [Resident, Graduate Program in Orthodontics], Geoffrey Greenlee, DDS, MSD, MPHb [Clinical Associate Professor], Anne Marie Bollen, DDS, MS, PhDc [Professor], JoAnna M. Scott, PhDd [Acting Assistant Professor], and Donald L. Chi, DDS, PhDe [Associate Professor] a
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected]
b
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected] c
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected] d
University of Washington School of Dentistry, Department of Pediatric Dentistry, Box 354915, Seattle, Washington 98115, USA, [email protected]
e
Author Manuscript
University of Washington School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, Washington 98195, USA
Abstract Introduction—We assess the relationship between race and orthodontic service utilization for Medicaid-enrolled children. Methods—This cross-sectional study focused on 570,364 Washington Medicaid-enrolled children ages 6-19 years. The main predictor variable was self-reported race (White versus nonWhite). The outcome variable was orthodontic service utilization, defined as children who were pre-authorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that non-Whites would be less likely to utilize orthodontic care than Whites.
Author Manuscript
Results—A total of 8,223 children were approved by Medicaid for orthodontic treatment and 7,313 received records and initiated treatment. Non-Whites were significantly more likely to
Corresponding Author: Donald L. Chi, DDS, PhD, University of Washington, School of Dentistry, Box 357475, Seattle, Washington 98195, USA, Phone: 206-616-4332, Fax: 206-685-4258, [email protected]. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ETHICS APPROVAL The study was approved by Washington State Institutional Review Board.
Merritt et al.
Page 2
Author Manuscript
utilize orthodontic care than Whites (Odds Ratio [OR]=1.18; 95% confidence interval [CI]=1.02, 1.36; p=.031). Hispanic non-White children were more likely to utilize orthodontic care than nonHispanic White children (OR=1.42; 95% CI=1.18, 1.70; p
Am J Orthod Dentofacial Orthop. Author manuscript; available in PMC 2017 April 01. Published in final edited form as: Am J Orthod Dentofacial Orthop. 2016 April ; 149(4): 516–522. doi:10.1016/j.ajodo.2015.09.025.
Racial Disparities in Orthodontic Service Utilization for Medicaid-Enrolled Children: An Evaluation of the Washington Medicaid Program
Author Manuscript
Jantraveus M. Merritt, DMD, MSDa [Resident, Graduate Program in Orthodontics], Geoffrey Greenlee, DDS, MSD, MPHb [Clinical Associate Professor], Anne Marie Bollen, DDS, MS, PhDc [Professor], JoAnna M. Scott, PhDd [Acting Assistant Professor], and Donald L. Chi, DDS, PhDe [Associate Professor] a
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected]
b
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected] c
University of Washington School of Dentistry, Department of Orthodontics, Box 357446, Seattle, Washington 98195, USA, [email protected] d
University of Washington School of Dentistry, Department of Pediatric Dentistry, Box 354915, Seattle, Washington 98115, USA, [email protected]
e
Author Manuscript
University of Washington School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, Washington 98195, USA
Abstract Introduction—We assess the relationship between race and orthodontic service utilization for Medicaid-enrolled children. Methods—This cross-sectional study focused on 570,364 Washington Medicaid-enrolled children ages 6-19 years. The main predictor variable was self-reported race (White versus nonWhite). The outcome variable was orthodontic service utilization, defined as children who were pre-authorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that non-Whites would be less likely to utilize orthodontic care than Whites.
Author Manuscript
Results—A total of 8,223 children were approved by Medicaid for orthodontic treatment and 7,313 received records and initiated treatment. Non-Whites were significantly more likely to
Corresponding Author: Donald L. Chi, DDS, PhD, University of Washington, School of Dentistry, Box 357475, Seattle, Washington 98195, USA, Phone: 206-616-4332, Fax: 206-685-4258, [email protected]. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ETHICS APPROVAL The study was approved by Washington State Institutional Review Board.
Merritt et al.
Page 2
Author Manuscript
utilize orthodontic care than Whites (Odds Ratio [OR]=1.18; 95% confidence interval [CI]=1.02, 1.36; p=.031). Hispanic non-White children were more likely to utilize orthodontic care than nonHispanic White children (OR=1.42; 95% CI=1.18, 1.70; p
