Analysis of hospital-based emergency department visits for dental caries in the United States in 2008
Corresponding Author
Andre Walker PhD
Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Correspondence
Dr. Andre Walker, Institute for Partnerships to Eliminate Health Disparities, 220 Stoneridge Drive, Suite 208, University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA. Tel.: 803-251-2232; Fax: 803-251-6327; e-mail: [email protected]. A. Walker is with the Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina. Janice C. Probst, Amy B. Martin, and Jessica D. Bellinger are with the Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina and South Carolina Rural Health Research Center. Anwar Merchant is with the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina.
Search for more papers by this authorJanice C. Probst PhD
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorAmy B. Martin Dr.PH
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorJessica D. Bellinger PhD
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorAnwar Merchant ScD
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Search for more papers by this authorCorresponding Author
Andre Walker PhD
Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Correspondence
Dr. Andre Walker, Institute for Partnerships to Eliminate Health Disparities, 220 Stoneridge Drive, Suite 208, University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA. Tel.: 803-251-2232; Fax: 803-251-6327; e-mail: [email protected]. A. Walker is with the Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina. Janice C. Probst, Amy B. Martin, and Jessica D. Bellinger are with the Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina and South Carolina Rural Health Research Center. Anwar Merchant is with the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina.
Search for more papers by this authorJanice C. Probst PhD
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorAmy B. Martin Dr.PH
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorJessica D. Bellinger PhD
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
South Carolina Rural Health Research Center, Columbia, SC, USA
Search for more papers by this authorAnwar Merchant ScD
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Search for more papers by this authorAbstract
Objectives
Using nationally representative data, we examined differences in dental care utilization in emergency departments (EDs) among working age adults associated with rural residence and lack of health insurance.
Methods
We used data from the 2008 Nationwide Emergency Department Sample, restricted to working age adults (ages 19-64; 16,928,424 observations). The dependent variable was a principal diagnosis of dental caries. The primary independent variable was patient's area of residence, rural versus urban. The control variables were payer, age, gender, median income, region, and admission timing. Logistic regression analysis was performed to determine the association with residence, payer, and other covariates. Multivariate logistic regression models were estimated.
Results
In 2008, there were an estimated 74 million ED visits among working adults ages 19-64 in the United States. Dental caries accounted for between 0.2 percent and 1.0 percent of all visits, depending on patient characteristics. Rural patients were significantly more likely than urban patients to have dental visits. Dental visits were more prevalent among patient with government insurance or self -pay relative to the privately insured.
Conclusions
The Affordable Care Act may reduce the proportion of self-pay visits for dental care. Medicaid expansion may not result in improved dental use among Medicaid patients unless dental services are covered and dental practitioners appropriately engaged.
References
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