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. 2022 Sep 9;3(9):e223041. doi: 10.1001/jamahealthforum.2022.3041

Table 3. Difference-in-Differences Estimates of the Association Between the Medicaid Fee Ratio and Children’s Oral Health and School Absences: 2016-2019 National Survey of Children’s Healtha.

Outcome No. of Medicaid-insured children Weighted baseline % Difference-in-differences estimate (95% CI) P value
Excellent condition of teeth
All 15 686 29 0.19 (0.01 to 0.36) .04
Subgroup analysis by race and ethnicity
Hispanic 3105 26 0.31 (0.11 to 0.50) .003
Non-Hispanic
Black 2140 33 0.25 (−0.41 to 0.92) .45
White [Reference] 8283 31 0.05 (−0.19 to 0.28) .70
Otherb 2158 27 −0.13 (−0.44 to 0.18) .41
Subgroup analysis by sex
Male [Reference] 8159 27 0.09 (−0.10 to 0.29) .35
Female 7527 31 0.26 (0.03 to 0.49) .03
At least 4 school absences
All 15 458 28 −0.07 (−0.21 to 0.06) .29
Subgroup analysis by race and ethnicity
Hispanic 3062 25 −0.03 (−0.35 to 0.29) .83
Non-Hispanic
Black 2095 24 0.14 (−0.21 to 0.49) .42
White [Reference] 8171 32 −0.08 (−0.28 to 0.12) .42
Other race 2130 36 −0.20 (−0.40 to 0.01) .06
Subgroup analysis by sex
Male [Reference] 8040 26 −0.01 (−0.22 to 0.19) .89
Female 7418 30 −0.14 (−0.30 to 0.03) .10
At least 7 school absences
All 15 458 15 −0.09 (−0.19 to 0.00) .06
Subgroup analysis by race and ethnicity
Hispanic 3062 13 −0.24 (−0.55 to 0.08) .13
Non-Hispanic
Black 2095 12 0.01 (−0.22 to 0.23) .96
White [Reference] 8171 18 −0.04 (−0.17 to 0.10) .60
Otherb 2130 16 −0.09 (−0.36 to 0.19) .54
Subgroup analysis by sex
Male [Reference] 8040 15 0.02 (−0.09 to 0.14) .71
Female 7418 14 −0.22 (−0.35 to −0.09)c .001
a

Estimates shown are in terms of percentage points. Weighted baseline rates are for Medicaid-enrolled children in 20 states with a year-over-year fee ratio change of at least 2 percentage points in absolute value and calculated before this change occurred, as described in the text. Difference-in-differences estimates represent the effect of a 1 percentage point increase in the fee ratio. Models include state and year as fixed effects in addition to the child and time-varying state-level controls (unemployment rate, Medicaid managed care penetration rate, dentist supply per capita, and Medicaid income eligibility limit for working parents). Estimates are weighted and model errors clustered at the state level. Subgroup estimates and tests for differences between each subgroup and the reference group are from models with a complete set of interactions between the subgroup indicators and the main analysis controls.

b

The other race category includes American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races.

c

Significant difference between the subgroup and reference group (P < .01).