Darling Brian G, Singhal Astha, Kanellis Michael J
University of Iowa College of Dentistry, Iowa City, IA, USA.
Henry M. Goldman School of Dentistry, Boston University, Boston, MA, USA.
J Public Health Dent. 2016 Mar;76(2):122-8. doi: 10.1111/jphd.12120. Epub 2015 Oct 1.
To examine the characteristics associated with emergency department (ED) utilization in Iowa for nontraumatic dental conditions (NTDCs), and those associated with having multiple visits to the ED for NTDCs before the Medicaid expansion program in Iowa.
State Emergency Department Database for Iowa was used for 2012, which comprised of all outpatient ED visits in the state. Logistic regression was used for bivariate and multivariable analyses to model the odds of visiting the ED for NTDCs, relative to other conditions, and odds of visiting the ED multiple times relative to a single time in 2012 for NTDCs. The hospital charges associated with the NTDC ED visits were also examined.
ED visits for NTDCs comprised 1.41% of all ED visits in Iowa during 2012 with a mean charge of $557. Of the patients presenting for NTDCs in 2012, 17% presented multiples times. Young adults, Medicaid enrollees or uninsured, and those residing in metropolitan areas had greater odds of presenting to the EDs for NTDCs compared with other conditions, and presenting multiple times to EDs for NTDCs. Those with more chronic conditions also had greater odds of repeatedly visiting the ED for NTDCs.
Low-income young adults in Iowa rely on EDs for their dental needs that can have substantial costs. The Dental Wellness Plan (DWP) is intended to facilitate dental care access by providing dental coverage to low-income Iowans. This study provides baseline data that will be used to evaluate the success of DWP in improving access to dental care.
研究爱荷华州非创伤性牙科疾病（NTDC）患者在急诊科（ED）就诊的相关特征，以及在爱荷华州医疗补助扩展计划实施前因NTDC多次前往急诊科就诊的相关特征。
使用2012年爱荷华州急诊科数据库，该数据库包含该州所有门诊急诊就诊记录。采用逻辑回归进行双变量和多变量分析，以建立相对于其他疾病因NTDC前往急诊科就诊的概率模型，以及相对于2012年因NTDC单次就诊而言多次就诊的概率模型。同时还研究了与NTDC急诊就诊相关的医院收费情况。
2012年爱荷华州因NTDC的急诊就诊占所有急诊就诊的1.41%，平均费用为557美元。2012年因NTDC就诊的患者中，17%为多次就诊。与其他疾病相比，年轻成年人、医疗补助参保者或未参保者以及居住在大都市地区的人因NTDC前往急诊科就诊的概率更高，且因NTDC多次前往急诊科就诊的概率也更高。患有更多慢性病的人因NTDC反复前往急诊科就诊的概率也更高。
爱荷华州的低收入年轻成年人依靠急诊科满足其牙科需求，这可能会产生高昂费用。牙科健康计划（DWP）旨在通过为低收入爱荷华州人提供牙科保险来促进牙科护理的可及性。本研究提供了基线数据，将用于评估DWP在改善牙科护理可及性方面的成效。
