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美国非创伤性牙科急诊就诊等候时间的种族和民族差异。

Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States.

机构信息

Department of Clinical Services, School of Dentistry, Marquette University, Milwaukee, Wis. 53201-1881, USA.

出版信息

J Am Dent Assoc. 2013 Jul;144(7):828-36. doi: 10.14219/jada.archive.2013.0195.

Abstract

BACKGROUND

Researchers have documented an association between waiting times in emergency departments (EDs) and quality of care for medical conditions, but little is known about trends and factors associated with waiting times for ED visits related to nontraumatic dental conditions (NTDCs). The authors examined trends in waiting time and associated factors for NTDC-related ED visits in the United States.

METHODS

The authors analyzed data from the National Hospital Ambulatory Medical Care survey for 1997 to 2007, excluding 2001 and 2002 owing to lack of information about waiting times. The authors used a survey-weighted linear regression of log-transformed waiting-time model to determine the waiting time for NTDC-related visits.

RESULTS

The geometric mean (standard error) waiting times for NTDC- and non-NTDC-related visits were 29 (1.0) and 25 (0.6) minutes, respectively (P < .01). The geometric mean waiting time for NTDC-related visits increased by 6 percent annually and from 20 minutes in 1997 to 37 minutes in 2007. Compared with whites, Hispanics and African Americans had significantly longer waiting times for NTDC-related visits (adjusted fold-difference [R] = 1.2, 95 percent confidence interval [CI] = 1.13-1.31) and [R] = 1.3, [CI] = 1.29-1.38). Age, payer type, reason for visit and triage category were significant predictors of waiting time (R = 2.3 and 2.4 for NTDC-related visits in the triage categories of more than one to two hours and more than two to 24 hours, respectively).

CONCLUSION

Nationally, waiting times in EDs for NTDC-related visits increased over time. Compared with whites, Hispanics and blacks waited longer to receive care for NTDCs in EDs.

PRACTICAL IMPLICATIONS

Prolonged waiting times associated with NTDC-related ED visits reinforce the need for dental professionals to continue to advise patients regarding the need to implement oral health preventive strategies and to avoid the use of the ED for preventable common dental conditions.

摘要

背景

研究人员已经记录了急诊部门(ED)的等待时间与医疗条件的护理质量之间的关联,但对于与非创伤性牙科疾病(NTDC)相关的 ED 就诊的等待时间的趋势和相关因素知之甚少。作者研究了美国与 NTDC 相关的 ED 就诊的等待时间趋势和相关因素。

方法

作者分析了 1997 年至 2007 年全国医院门诊医疗调查的数据,由于缺乏有关等待时间的信息,因此排除了 2001 年和 2002 年的数据。作者使用对数转换后的等待时间模型的调查加权线性回归来确定与 NTDC 相关的就诊的等待时间。

结果

NTDC 相关就诊和非 NTDC 相关就诊的几何平均值(标准误差)等待时间分别为 29(1.0)和 25(0.6)分钟(P<.01)。NTDC 相关就诊的几何平均等待时间每年增加 6%,从 1997 年的 20 分钟增加到 2007 年的 37 分钟。与白人相比,西班牙裔和非裔美国人的 NTDC 相关就诊的等待时间明显更长(调整后的倍数差异[R] = 1.2,95%置信区间[CI] = 1.13-1.31)和[R] = 1.3,[CI] = 1.29-1.38)。年龄,付款类型,就诊原因和分类类别是等待时间的重要预测因素(R = 2.3 和 2.4,用于分类类别中的 NTDC 相关就诊,超过一个至两个小时和超过两个至 24 小时)。

结论

从全国范围来看,与 NTDC 相关的就诊在 ED 中的等待时间随着时间的推移而增加。与白人相比,西班牙裔和黑人在 ED 中等待接受 NTDC 治疗的时间更长。

实践意义

与 NTDC 相关的 ED 就诊相关的长时间等待时间,强调了牙科专业人员继续向患者提供有关实施口腔健康预防策略和避免将 ED 用于可预防的常见牙科疾病的必要性。

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