BACKGROUND: Child Health Investment Partnership (CHIP) of Roanoke Valley is a home visiting program that promotes children’s health and family self-sufficiency. CHIP’s Begin With a Grin program provides preventive dental services in the home (oral health anticipatory guidance and fluoride varnish) for children aged 0 to 6 years. The purpose of this study was to compare the dental utilization of Medicaid-enrolled children in CHIP versus Medicaid-enrolled children not in CHIP. METHODS: Using the propensity score method, control subjects were selected from the statewide Medicaid database by using a caliper-matching algorithm. A vector of chosen covariates was used to match control subjects; these covariates included risk factors, estimated propensity score, age, race, gender, and days of Medicaid eligibility. Propensity scores were developed by using a logistic regression. Differences in dental utilization outcomes were tested: ≥1 dental claim (logistic regression) and number of dental claims (Poisson regression) for each subject within the test period. RESULTS: When CHIP children were compared with Medicaid-only children, the CHIP child was 3 times more likely to have at least 1 dental visit (odds ratio: 3.0 [95% confidence interval: 1.9–4.7]) and have a higher number of dental claims (ratio of estimated average number of dental claims [cases/control]: 8.60/3.05 = 2.82 [95% confidence interval: 2.56–3.12]). CONCLUSIONS: A home visiting model can introduce children and their families to dental prevention, improve dental health literacy, establish a dental home, and provide application of fluoride varnish.
The Child Health Investment Partnership of the Roanoke Valley (CHIP-RV), Virginia, USA, has been helping at risk children and families for the past 24 years. CHIP-RV began as a grassroots effort involving local pediatricians, social service agencies, and the public health department. Working together these professionals have developed and implemented a comprehensive program that provides for health care coordination, family strengthening services, and mental health services all directed at the mission of promoting health of medically underserved children within the greater Roanoke Valley. CHIP services are directed at low-income pregnant women and children from birth to kindergarten entry. Services include home visits with an RN, medical records reviews, inhome comprehensive assessments, health education, preparation for kindergarten, support for management of difficult behaviors, skill development, home and child safety, dental varnish application, and transportation to health and social services. Evaluations of the CHIP-RV model has shown CHIP-RV to be successful at meeting selected health and social needs of at-risk children and families. It is a model that should successfully interface with the Affordable Care Act as well as private/public efforts to reduce the cost of health care, help families to utilize the health care system and keep children well.
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