Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97

Objective: This study compared types and costs of dental services rendered to children who had received care in a hospital operating room (H) with chi ldren who had not (NH). Methods: The study population consisted of all chil dren aged 1-5 years who received a dental service reimbursed by the Louisia na Medicaid EPSDT program from October 1996 through September 1997. Claim f iles were provided by the Louisiana Bureau of Health Services Financing. A treatment intensify index [TII = 3*(# extractions) + 2*(# pulpotomies + # c rowns) + # simple restorations] was calculated for H children (n = 2, 142) and NH children (n = 38,423). Using logistic regression, a dichotomous hosp italization variable (H vs NH) was regressed against treatment intensity an d selected personal and parish (county) characteristics for each of the fiv e age groups. Total and average reimbursement per child were calculated for both groups of children, by age. Results: The mean treatment intensity sco res for H and NH children were 24.02 (SD = 11.82) and 2.16 (SD = 4.78), res pectively. For all age groups, children with treatment intensity scores gre ater than 8 were at least 132 times more likely to be hospitalized than wer e children with scores less than or equal to 8. The mean cost for care prov ided to H children was $1,508 compared with $104 for NH. Total costs for de nial care rendered to H children (5% of the study population) were $3,229,8 51 (45% of fetal dental costs for the study population). Conclusion: Reduci ng severe caries through early interventions could provide substantial cost savings.