Children's Utilization of the U.S. Military Dental Insurance

Authors
Chaffin, J. G. Moss, D. Martin, G. Leiendecker, T. Mascarenhas, A. K.
Publication year
2013
Citation Title
Children's utilization of the U.S. Military dental insurance.
Journal Name
Military Medicine
Journal Volume
178
Issue Number
7
Page Numbers
816-818
DOI
10.7205/milmed-d-13-00089
Summary
Claims data were used to assess child utilization of the TRICARE Dental Program for a dental check-up at least once during a period of a year. The majority of children enrolled in the TRICARE Dental Program had at least one dental check-up during the study year. Children of officers and warrant officers had significantly higher odds of utilizing TRICARE Dental Program than children of enlisted rank families.
Key Findings
Children of military officers and warrant officers had higher odds of utilizing TRICARE Dental Program for a dental visit at least once per year than children of an enlisted E1-E4 rank parent.
Overall, 71% of military children had at least one annual dental visit.
Sixty-six percent of children from enlisted rank families and 83% of children from officer or warrant officer families utilized TRICARE Dental Program during a year’s span.
Implications for Program Leaders
Offer workshops to military parents about the TRICARE Dental Program for their children
Educate military parents on the importance of regular preventative dental care for optimal oral health
Disseminate information about registering for TRICARE and the services available to military families
Implications for Policy Makers
Continue to support programs that advocate for all children to have had an annual dental exam as part of their requirements for entering school each year
Continue to support programs that provide some incentive for military children to have annual dental exams
Encourage collaboration among DoD and community-based dental offices to coordinate and streamline dental care
Methods
A secondary data analysis was conducted to determine the rates at which military children utilize the TRICARE Dental Program.
Claims data from February 1, 2010 – January 31, 2011 were utilized for the current study.
Age and gender of child, as well as military rank, age, and gender of sponsor were included in the data file.
Participants
Data from 378,681 military children world-wide who were continuously enrolled in TRICARE dental program were examined.
Children were between the ages of 1-18 years (mean= 10 years).
No other demographic data were provided (e.g., gender, race, service branch).
Limitations
This study does not take into consideration military children who may utilize private dental insurance for dental visits, which limits generalizability of results.
Limited participant statistics were reported, so we do not know whether there are different TRICARE dental program utilization rates among the different branches of the military.
This study used military rank as a proxy for socio-economic status, but never explicitly measured socio-economic status (i.e., through family income), which may bias results.
Avenues for Future Research
Investigate the barriers tomilitary families utilizing TRICARE dental services
Examine differences in TRICARE dental program utilization rates associated with child’s age, branch of military, and geographical location
Include different measures of socio-economic status, including pay scale or household income
Design Rating
1 Star - There are some significant flaws in the study design or research sample such that conclusions drawn from the data are suspect.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
1 Star - There are several factors that limit the ability to extend the results to a population and therefore the results can only be extended to a very specific subset of the population.
Focus
Multiple Branches
Population Focus
Military Component
Abstract
Objectives: The objectives of this study were to determine the dental utilization of children enrolled in a military dental insurance program and to assess if utilization differs by socioeconomic status. Methods: Claims data for children enrolled in the Department of Defense TRICARE Dental Program for the period of February 1, 2010 through January 31, 2011 were used to identify children who had a dental visit during that benefit year. Results: Of the 376,681 continuously enrolled children, 266,862 (71%) had at least one dental visit during the benefit year. 82.7% of children of officers had a dental visit, as compared to 66.4% of children from enlisted families. There was a difference in dental utilization based on the military rank of the sponsors (?2 = 8,939.39, df = 1, p< 0.0001). Children of officers were 2.5 times (95% confidence intervals = 2.44–2.61), and children of warrant officers were 1.6 times (95% confidence intervals = 1.51–1.74) more likely to have a dental visit than children from enlisted families. The results also show utilization trends within the enlisted and officer categories with higher utilization among more senior personnel. Conclusions: Socioeconomic status does play a role in dental care-seeking behavior of military families. Even when families voluntarily enroll in a program and there are no cost shares for services such as preventive services, there may be other barriers to accessing care that need to be addressed so that all groups can maximize their oral health.
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