Allareddy Veerasathpurush, Rampa Sankeerth, Lee Min Kyeong, Allareddy Veerajalandhar, Nalliah Romesh P
Dr. Veerasathpurush Allareddy is an associate professor, Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, 801 Newton Road, Dental Science Building, Iowa City, Iowa 52242,
J Am Dent Assoc. 2014 Apr;145(4):331-7. doi: 10.14219/jada.2014.7.
Untreated dental conditions may progress to lesions that are severe enough to necessitate emergency visits to hospitals. The authors conducted a study to investigate nationally representative trends in U.S. hospital-based emergency department (ED) visits involving dental conditions and to examine patient-related characteristics associated with ED charges.
The authors used the Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality, for the years 2008 through 2010. They selected all ED visits involving patients with a diagnosis of either dental caries, pulpal or periapical lesions, gingival or periodontal conditions, or mouth cellulitis or abscess. Outcomes examined included post-ED disposition status and hospital ED charges.
During the study period, 4,049,361 ED visits involved diagnosis of a dental condition, which is about 1 percent of all ED visits occurring in the entire United States. Uninsured patients made about 40.5 percent of all dental condition-related ED visits. One hundred one patients in the study died in EDs. The mean hospital ED charge per visit was approximately $760 (adjusted to 2010 dollars), and the total ED charges across the entire United States during the three-year study period was $2.7 billion.
Patients without insurance are a cohort at high risk of seeking dental care in hospital-based ED settings. A substantial amount of hospital resources are used to treat dental conditions in ED settings. Patients with mouth cellulitis, periodontal conditions and numerous comorbidities are likely to incur higher ED charges.
Dental conditions can be treated more effectively in a dental office setting than in hospital-based settings.
未经治疗的牙齿疾病可能会发展为严重病变，以至于需要前往医院急诊。作者开展了一项研究，以调查美国医院急诊科涉及牙齿疾病就诊情况的全国代表性趋势，并研究与急诊费用相关的患者特征。
作者使用了由医疗保健研究与质量局赞助的医疗保健成本和利用项目的全国急诊科样本，数据涵盖2008年至2010年。他们选取了所有涉及诊断为龋齿、牙髓或根尖周病变、牙龈或牙周疾病、或口腔蜂窝织炎或脓肿的患者的急诊就诊病例。研究的结果包括急诊后处置状态和医院急诊费用。
在研究期间，4,049,361次急诊就诊涉及牙齿疾病诊断，约占美国全部急诊就诊次数的1%。无保险患者的急诊就诊次数约占所有与牙齿疾病相关急诊就诊次数的40.5%。研究中有101名患者在急诊科死亡。每次急诊就诊的平均医院急诊费用约为760美元（按2010年美元调整），在为期三年的研究期间，美国全国的急诊总费用为27亿美元。
未参保患者是在医院急诊科寻求牙齿治疗的高危人群。大量医院资源用于在急诊科治疗牙齿疾病。患有口腔蜂窝织炎、牙周疾病和多种合并症的患者可能产生更高的急诊费用。
牙齿疾病在牙科诊所环境中比在医院环境中能得到更有效的治疗。
