Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community

Abstract

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04-1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88-0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

Dental emergencies presenting to maxillofacial units during the COVID-19 pandemic: a five-centre UK hospital study

“…This allowed for data analysis and gave valuable insights into patient management as well as staff timetable management during the peak of the pandemic. Dental emergencies comprise a significant proportion of hospital A&E attendances, 13 and generate a steady referral source for secondary and tertiary care providers such as oral and maxillofacial surgery (OMFS). 14,15 Patients presenting to A&E departments consistently and regularly report having nowhere else to turn to with their acute dental problem, 13,15 or simply having (sometimes multiple) antibiotic courses provided rather than any definitive treatment.…”

“…Dental emergencies comprise a significant proportion of hospital A&E attendances, 13 and generate a steady referral source for secondary and tertiary care providers such as oral and maxillofacial surgery (OMFS). 14,15 Patients presenting to A&E departments consistently and regularly report having nowhere else to turn to with their acute dental problem, 13,15 or simply having (sometimes multiple) antibiotic courses provided rather than any definitive treatment. This has become much more significant and burdensome on the hospital system and specialties such as OMFS of late due to the pandemic lockdown, with the closure of much of the primary dental care sector and emergency dental care being restricted to a handful of urgent dental hubs.…”

Série histórica de atendimentos de urgência odontológica no Brasil entre 2008 e 2015

“…Algumas condições de saúde são mais sensíveis a melhorias no acesso na atenção primária, em sua maioria as condições agudas ou crônicas agudizadas respondem mais rapidamente a dinâmica destas complexas interações. Assim, por exemplo, encontramos estudos em sistemas não universais que buscam entender o efeito de barreiras ao acesso a atenção primária e o uso de serviços hospitalares que prestam atendimento de urgência odontológica, bem como estudos em sistemas universais que buscam entender os determinantes de uso de serviços e as interfaces na rede de atenção às urgências odontológicas [1][2][3][4][5][6] . No Brasil, estudos vinculados ao atendimento de urgência odontológica são realizados em sua maioria em serviços de atenção secundária havendo maior escassez de estudos que considerem a rede de atenção como um todo 7 .…”

Relevance of dental care in hospitals: a brief systematic review

“…Thus, persistently high rates of preventable dentistry-related hospitalizations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita. Therefore, health service planners and policymakers should seek alternative indicators of accessibility to dental services [7].…”