Caregivers’ Health Literacy and Their Young Children’s Oral-health–related Expenditures

Caregivers’ health literacy has emerged as an important determinant of young children’s health care and outcomes. We examined the hypothesis that caregivers’ health literacy influences children’s oral-health-care–related expenditures. This was a prospective cohort study of 1,132 child/caregiver dyads (children’s mean age = 19 months), participating in the Carolina Oral Health Literacy Project. Health literacy was measured by the REALD-30 (word recognition based) and NVS (comprehension based) instruments. Follow-up data included child Medicaid claims for CY2008-10. We quantified expenditures using annualized 2010 fee-adjusted Medicaid-paid dollars for oral-health–related visits involving preventive, restorative, and emergency care. We used descriptive, bivariate, and multivariate statistical methods based on generalized gamma models. Mean oral-health–related annual expenditures totaled $203: preventive—$81, restorative—$99, and emergency care—$22. Among children who received services, mean expenditures were: emergency hospital-based—$1282, preventive—$106, and restorative care—$343. Caregivers’ low literacy in the oral health context was associated with a statistically non-significant increase in total expenditures (average annual difference =$40; 95% confidence interval, -32, 111). Nevertheless, with both instruments, emergency dental care expenditures were consistently elevated among children of low-literacy caregivers. These findings provide initial support for health literacy as an important determinant of the meaningful use and cost of oral health care

Caregivers’ Health Literacy and Their Young Children’s Oral-health–related Expenditures

Caregivers’ health literacy has emerged as an important determinant of young children’s health care and outcomes. We examined the hypothesis that caregivers’ health literacy influences children’s oral-health-care–related expenditures. This was a prospective cohort study of 1,132 child/caregiver dyads (children’s mean age = 19 months), participating in the Carolina Oral Health Literacy Project. Health literacy was measured by the REALD-30 (word recognition based) and NVS (comprehension based) instruments. Follow-up data included child Medicaid claims for CY2008-10. We quantified expenditures using annualized 2010 fee-adjusted Medicaid-paid dollars for oral-health–related visits involving preventive, restorative, and emergency care. We used descriptive, bivariate, and multivariate statistical methods based on generalized gamma models. Mean oral-health–related annual expenditures totaled $203: preventive—$81, restorative—$99, and emergency care—$22. Among children who received services, mean expenditures were: emergency hospital-based—$1282, preventive—$106, and restorative care—$343. Caregivers’ low literacy in the oral health context was associated with a statistically non-significant increase in total expenditures (average annual difference =$40; 95% confidence interval, -32, 111). Nevertheless, with both instruments, emergency dental care expenditures were consistently elevated among children of low-literacy caregivers. These findings provide initial support for health literacy as an important determinant of the meaningful use and cost of oral health care