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 |
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.
The other race category includes American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races.
Significant difference between the subgroup and reference group (P < .01).