Date of Award

1-1-2012

Document Type

Campus Access Dissertation

Department

Health Services and Policy Management

First Advisor

Probst, Janice C

Abstract

There is a dearth of published studies presenting nationally representative estimates and risk factors of hospital-based emergency department visits primarily attributed to dental complaints. The objective of this study is to provide estimates hospital- based emergency department visits of among working adults.

The Nationwide Emergency Department Sample, a component of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality, was used for this study. All emergency department visits attributed to oral cavity, salivary glands, and jaw were identified using ICD-9-CM diagnosis codes and selected for analysis. From this data, all ED visits in which one of the reasons for the visit was toothache or tooth injury were compiled and used to determine national estimates of counts and rates of ED visits for dental related complaints. Outcomes including primary dental diagnosis and decay were examined. Simple descriptive characteristics were used to summarize the data. Logistic regression analysis on the outcome variable, presentation to the ED with a primary dental diagnosis (versus other problem), was performed to determine the association with residence, payer, and other covariaties.

This study found that in 2008, there were an estimated 16.9 million ED visits in among working adults in the United States. Approximately, 41% of all dental related visits occurred among the uninsured. Multivariate logistic regression results indicated that the adjusted odds of presenting to the ED for a dental complaint compared to other problems were significantly elevated for visits in which government or self - pay was listed as the payer relative to those with private insurance.

ED's are an important point of care for dental -related complaints, particularly for individuals who lack private insurance. Policy threads may provide some solutions to address the use of ED for oral health care complaints.

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