Impact of the Iowa S-SCHIP program on access to dental care for adolescents.

PURPOSE This study examined whether providing insurance through Iowa's State Children's Health Insurance Program, S-SCHIP, had an impact on dental care access for adolescents that was similar to children of other age groups. METHODS Using a pretest, post-test panel study design, an 80-item questionnaire was mailed to the parents of one S-SCHIP enrollee per household at enrollment. A similar instrument was mailed after 1 year. A mixed-mode data collection process was used. Children were compared by age groups (1 to 6, 7 to 12, and 13 to 18). Statistical tests evaluated differences in: (1) demographics between age groups at baseline; (2) outcomes at follow-up; and (3) differences between matched-pair responses prepost. RESULTS Baseline and follow-up responses were received from 39% of sampled children (N = 1,399). After 1 year, access to and utilization of dental services improved for all age groups. Adolescents, however, were least likely to have had an annual dental visit; 1 in 6 still had unmet dental need or delays. Relative to other health services, dental care was reported to be the highest area of unmet need at both baseline and follow-up, especially for adolescents. CONCLUSIONS Iowa's S-SCHIP program was found to improve dental care access for children of all ages. Nonfinancial barriers, however, still exist for a significant number of adolescents.