Health Services Research, Administration and Policy Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
Health Services Research, Administration and Policy Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
J Evid Based Dent Pract. 2017 Jun;17(2):83-91. doi: 10.1016/j.jebdp.2016.11.007. Epub 2016 Dec 9.
This study aims to provide estimates of hospital-based emergency department (ED) visits due to dental conditions in Nebraska and to examine patient-related characteristics associated with ED charges. In addition, this study provides dental-related ED visits and distribution of dentists by county.
For the study, we used the State Emergency Department Database for Nebraska for the years 2011 through 2013 and the Health Resources and Services Administration's Area Health Resource File. All ED visits with dental conditions in Nebraska were selected. The primary outcome variable was hospital-based ED charges. Multivariable linear regression model was used to examine the effects of patient-related factors on ED charges.
During the study period, a total of 9943 dental-related ED visits occurred. Of these, 55.5% patients aged between 25 and 44 years. Thirty-nine percent of all dental ED visits had patients who were self-financed or uninsured. Twenty counties in Nebraska do not have a dentist, and nine counties had more than 50 ED visits per 10,000 population. Patients residing in urban areas paid significantly higher charges than those living in rural towns, small rural towns, or isolated rural areas. The mean and total ED charges attributed to dental conditions for the entire study period were $934 and $9.3 million, respectively.
Patients who are uninsured, aged 25-44 years, covered by private insurance, and residing in urban areas are identified to be at high risk. There is a need to develop health policies and programs to improve access to dental care in rural states.
本研究旨在估计内布拉斯加州因牙科状况而导致的医院急诊部（ED）就诊人数，并检查与 ED 费用相关的患者特征。此外，本研究还提供了与牙科相关的 ED 就诊情况以及按县分布的牙医信息。
在这项研究中，我们使用了内布拉斯加州 2011 年至 2013 年的州急诊部数据库和卫生资源与服务管理局的区域卫生资源档案。选择了所有有牙科状况的 ED 就诊。主要因变量是基于医院的 ED 费用。我们使用多变量线性回归模型来检验患者相关因素对 ED 费用的影响。
在研究期间，共发生了 9943 次与牙科相关的 ED 就诊。其中，55.5%的患者年龄在 25 岁至 44 岁之间。所有牙科 ED 就诊中有 39%的患者是自费或没有保险的。内布拉斯加州有 20 个县没有牙医，有 9 个县每 10000 人口的 ED 就诊次数超过 50 次。居住在城市地区的患者比居住在农村城镇、小型农村城镇或偏远农村地区的患者支付的费用要高得多。整个研究期间，归因于牙科状况的平均和总 ED 费用分别为 934 美元和 9300 万美元。
未参保、年龄在 25-44 岁之间、有私人保险、居住在城市地区的患者被认为是高风险人群。需要制定卫生政策和计划，以改善农村地区的牙科保健服务。
