131 - Education Expenditure and Preventive Dental Care in Washington Children

Purpose: The aim of this retrospective, cross-sectional analysis of Medicaid claims data was to evaluate the relationship between public education expenditure and preventive dental care in Medicaid-enrolled children in Washington. 

Methods: Children ages 5-18 years old, enrolled in Washington state Medicaid, were geocoded into public school districts.  Enrollee claims data for 2019 were then compared to the corresponding school district’s per-pupil expenditure.  The primary outcome was school district-level preventive dental care utilization.  Results were tested for significance with ANOVA with Tukey post-hoc tests.

Results: The sample included 735,457 children enrolled in Washington state Medicaid.  Mean enrollee age was 11.2 years (SD 4.1), 49% of enrollees were female, 50% were white and 84% were considered rural.  Approximately 46% of all enrollees accessed preventive dental care during the study period.  When stratified into quartiles, there was a significant negative association between public education expenditure and preventive dental care.  Children in the highest spending school districts ( > $17,538 per pupil) utilized preventive dental care significantly less than all other children (0.40; SD 0.09; P < .01).

Conclusion: Children enrolled in the highest spending public school districts were the least likely of all Medicaid-enrolled children to utilize preventive dental care.  Future research should address the underutilization of preventive dental care for Medicaid-enrolled children and investigate policy considerations for public education expenditure as it relates to public health.

Identify Supporting Agency and Grant Number: Research supported by the Department of Pediatric Dentistry at the University of Washington School of Dentistry and the Washington State Academy of Pediatric Dentistry Foundation