Oral health needs and Medicaid reimbursement in a school-based program

Thesis (M.A.)--Boston UniversityThe disparities that exist in oral health are alarming with different people groups being affected more severely than others. Various public health initiatives have been suggested as ways to help combat these disparities, one of these being school-based oral health programs. These programs can provide many services to students, including: oral health education, dental screenings and referrals, fluoride treatment, dental sealants, and restorative treatments. It is also important for programs such as these to target those areas with the greatest need (high percentages of untreated dental decay) but also areas where reimbursement from public insurance will allow the programs to remain sustainable. The percentage of students participating in the National School Lunch Program is a way to do this since it is based on family income in relation to the federal poverty level. The Medicaid program is also a needs-based program that covers the costs of healthcare for the poor. Many students eligible for free and reduced-price lunches are also eligible for Medicaid. Boston University's Henry M. Goldman School of Dental Medicine (BUGSDM) has a department which manages school-based oral health programs servicing the cities of Boston, Natick, Framingham, Chelsea, and Lawrence, Massachusetts. In this project, data from each program for the 2011-2012 academic year was used to compare efforts, outcomes, and sustainability for each program, as well as gather descriptive data. This data was also used to determine how well the percentage of children in a school district participating in the national school lunch program predicts rates of untreated decay. Additionally, data collected from the BUGSDM’s school-based oral health programs was used to determine how well the percentage of children in a school district participating in the national school lunch program predicts enrollment in a public insurance program, MassHealth. Lastly, other city/town-level variables from the 2010 census were analyzed with our data to see if any of these were better predictors of untreated decay and MassHealth enrollment other than participation in the national school lunch program. [TRUNCATED