Huang Shulamite Sian, Wang Scarlett, Gold Heather T
Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, USA.
New York University Wagner Graduate School of Public Service, New York, New York, USA.
J Am Coll Emerg Physicians Open. 2025 Mar 11;6(2):100094. doi: 10.1016/j.acepjo.2025.100094. eCollection 2025 Apr.
All traditional dental clinics were closed from March to May 2020 due to the COVID-19 shutdown, potentially causing additional strain on hospital emergency departments (EDs) to care for patients with dental conditions. We evaluated the impact of pandemic-associated dental office closures on the share of dental conditions managed in EDs among children on Medicaid.
We quantified the change in the dental-related ED burden among publicly insured children before, during, and after pandemic dental office closures across NY using 2018-2020 New York State (NY) Medicaid claims data among children under age 19 using a difference-in-differences approach.
After controlling for seasonality, dental practice closures in 2020 in NY led to a 2.31 percentage point increase in the share of dental conditions seen in EDs ( < .01) among children on Medicaid, representing a 62% increase over 2019 levels. This was sustained even after reopening in May 2020 (1.26 percentage point increase in the reopening phase, < .01). The increases in the dental-related ED burden during dental office closures were due to the increased use of EDs for dental conditions.
Lack of access to dental care during a time of significant health care system strain was associated with an increased burden on EDs from dental conditions among publicly insured children. Health care systems should consider alternatives to referral programs to dental offices to ensure publicly insured children do not fall through the dental safety net, such as by providing limited dental services on-site or incorporating urgent dental care clinics within hospitals.
由于2020年3月至5月因新冠疫情而关闭所有传统牙科诊所，可能给医院急诊科（ED）护理有牙科疾病的患者带来额外压力。我们评估了与大流行相关的牙科诊所关闭对医疗补助儿童在急诊科接受治疗的牙科疾病比例的影响。
我们采用双重差分法，利用2018 - 2020年纽约州（NY）19岁以下儿童的医疗补助索赔数据，量化了纽约州在大流行期间牙科诊所关闭之前、期间和之后，公共保险儿童中与牙科相关的急诊科负担变化。
在控制季节性因素后，2020年纽约州牙科诊所关闭导致医疗补助儿童在急诊科接受治疗的牙科疾病比例增加了2.31个百分点（P <.01），比2019年水平增加了62%。即使在2020年5月重新开业后，这一比例仍持续上升（重新开业阶段增加了1.26个百分点，P <.01）。牙科诊所关闭期间与牙科相关的急诊科负担增加是由于因牙科疾病而增加了对急诊科的使用。
在医疗保健系统面临巨大压力期间无法获得牙科护理，与公共保险儿童因牙科疾病给急诊科带来的负担增加有关。医疗保健系统应考虑替代转诊至牙科诊所的方案，以确保公共保险儿童不会脱离牙科安全网，例如通过在现场提供有限的牙科服务或在医院内设立紧急牙科护理诊所。
