Brian G Darling1, Astha Singhal2, Michael J Kanellis3. 1. University of Iowa College of Dentistry, Iowa City, IA, USA. 2. Henry M. Goldman School of Dentistry, Boston University, Boston, MA, USA. 3. Clinic Administration, University of Iowa, Iowa City, IA, USA.
Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.