Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States

Okunseri, Christopher; Okunseri, Elaye; Chilmaza, Cesar A.; Harunani, Shazeen; Xiang, Qun; Szabó, Anikó

doi:10.14219/jada.archive.2013.0195

Cited by 22 publications

(15 citation statements)

References 19 publications

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“…Consistent with previous research, our results confirm and highlight the racial disparities in NTDC visits . Black individuals continue to have the highest rates of NTDCs in the population in both states.…”

Section: Discussionsupporting

confidence: 91%

Trends in non‐traumatic dental emergency department use in New York and New Jersey: a look at Medicaid expansion from both sides of the Hudson River

Laniado

Brow²,

Tranby³

et al. 2019

J Public Health Dent

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Objective The aim of this study was to examine the effect of Medicaid expansion on non‐traumatic dental condition (NTDC) emergency department visits in New York (NY) and New Jersey (NJ). Methods The 2010–2014 State Emergency Department Databases for NY and NJ were analyzed. NTDCs were defined as ICD‐9‐CM codes 520.0–529.9. Primary payers for ED discharges and patient's race were considered. Results In NY, from 2010 to 2011, there was a 51 percent decrease in private insurance and a 91 percent increase in Medicaid for NTDCs. In NJ, with the 2014 expansion, NTDCs fell 35 percent for uninsured and rose 57 percent for Medicaid. Black individuals have by far the highest population rates of NTDC ED visits, particularly in NJ. Conclusions The experiences in NY and NJ suggest that the timing of expansion had significant effects on payer distribution for NTDCs. Racial disparities continue exist with black individuals disproportionately accessing EDs for NTDCs.

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Section: Discussionsupporting

confidence: 91%

Trends in non‐traumatic dental emergency department use in New York and New Jersey: a look at Medicaid expansion from both sides of the Hudson River

Laniado

Brow²,

Tranby³

et al. 2019

J Public Health Dent

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show abstract

“…These findings are not surprising given that socioeconomic vulnerability is one of the most consistent correlates of ED use for NTDCs (Lewis, Lynch, & Johnston, 2003; Nalliah, Allareddy, Elangovan, Karimbux, & Allareddy, 2010; Hong et al, 2011; McCormick, Abubaker, Laskin, Gonzales, & Garland, 2013; Okunseri, Okunseri, Chilmaza, Haurnani, Xiang, & Szabo, 2013). In addition, while community size was not significantly associated with ED use for children, adults in smaller communities had significantly greater odds of ED use than adults living in metropolitan areas.…”

Section: Discussionmentioning

confidence: 80%

“…Use of the emergency department (ED) for management of non-traumatic dental conditions (NTDCs) is a growing problem in the U.S. (Wall, 2012; Lee, Lewis, Saltzman, & Starks, 2012), especially among vulnerable population subgroups such as individuals without health insurance, Medicaid enrollees, and minorities (Lewis, Lynch, & Johnston, 2003; Nalliah, Allareddy, Elangovan, Karimbux, & Allareddy, 2010; Hong et al, 2011; McCormick, Abubaker, Laskin, Gonzales, & Garland, 2013; Okunseri, Okunseri, Chilmaza, Harunani, Xiang, & Szabo, 2013). It is common for State legislatures to eliminate Medicaid dental benefits to balance budgets, which leads to greater unmet dental care needs and subsequent ED admissions (Cohen, Manski, & Hooper, 1996; Wallace, Carlson, Mosen, Snyder, & Wright, 2011).…”

mentioning

confidence: 99%

“…Individuals with poor access to office-based dental care services commonly use the ED for management of dental pain and infection (Dorfman, Kastner, & Vinci, 2001; Patel, Miner, & Miner, 2012). Most studies report individual-level risk factors associated with ED admission for NTDCs (e.g., age, gender, race/ethnicity, income, health insurance status and type) (Wall, 2012; Lee, Lewis, Saltzman, & Starks, 2012; Lewis, Lynch, & Johnston, 2003; Nalliah, Allareddy, Elangovan, Karimbux, & Allareddy, 2010; Hong et al, 2011; McCormick, Abubaker, Laskin, Gonzales, & Garland, 2013; Okunseri, Okunseri, Chilmaza, Harunani, Xiang, & Szabo, 2013; Cohen, Manski, & Hooper, 1996; Wallace, Carlson, Mosen, Snyder, & Wright, 2011). Despite evidence suggesting that individuals with intellectual and developmental disabilities (IDDs) are at risk for dental disease and poor access to timely dental care (Authors, 2011a; Morgan et al, 2012), no published studies to date have examined NTDC-related ED admissions for individuals with IDDs.…”

mentioning

confidence: 99%

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U.S. Emergency Department Admissions for Nontraumatic Dental Conditions for Individuals With Intellectual and Developmental Disabilities

Donald¹,

Masterson²,

Wong³

2014

Intellectual and Developmental Disabilities

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We hypothesized that individuals with intellectual and developmental disabilities (IDDs) are more likely to have an emergency department (ED) admission for non-traumatic dental conditions (NTDCs). We analyzed 2009 U.S. National Emergency Department Sample data and ran logistic regression models for children ages 3-17 years and adults ages 18+ years. The prevalence of NTDC-related ED admissions was 0.8% for children and 2.0% for adults. Children with IDDs were at increased odds of NTDC-related ED admission, but this difference was not statistically significant (pOR=1.06; 95% CI=0.91,1.23). Adults with IDDs had significantly lower odds of an ED admission for NTDCs (pOR=0.49;95% CI=0.44,0.54). Children with IDDs are not at increased odds of NTDC-related ED admissions whereas adults with IDDs are at significantly reduced odds.

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“…Evidence from Wisconsin, New Jersey, and Maryland demonstrates that Black Americans, especially those with no or public insurance and of low socioeconomic status, have higher rates of ED visits than whites (7–10). The most commonly cited reasons for these high rates include poor overall and oral health combined with a lack of access to dental insurance and care (7–9, 11–13).…”

Section: Introductionmentioning

confidence: 99%

Racial Disparities in Emergency Department Utilization for Dental/Oral Health-Related Conditions in Maryland

Chalmers¹

2017

Front. Public Health

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ObjectivesHospital emergency departments (EDs) are a place where many Americans seek treatment of dental conditions. Racial and ethnic minorities consistently have higher rates of ED utilization than whites for dental conditions. The reasons for these disparities and significant public health concerns are investigated less often. In this paper, we measure trends in racial disparities in ED discharges for dental conditions in Maryland from 2010 to 2013. To understand these disparities, we also describe differences between racial groups in age, gender, income, location, payer, comorbidities, and the availability of dental care.Methods2010–2013 State Emergency Department Data for Maryland were used in the analysis. Rates per 100,000 of the population are calculated using information from census population estimates. Cost-to-charge ratios are used to estimate the costs of ED discharges. Dental/oral health-related conditions (DOHRC) are defined as discharge diagnoses of ICD-9-CM codes 520.0 through 529.9. Descriptive statistics and fixed effects logistic regression models with a rare event correction are used to analyze the data.ResultsBlacks, especially females aged 25–34, have larger proportions of total ED discharges due to DOHRC, and higher population rates of DOHRC, than any other racial or ethnic group. In 2013, Blacks represented 30% of Maryland’s population and accounted for 52% of ED costs for DOHRC. Hispanics and those of other races have much lower rates of DOHRC discharges. The regression results show that the high proportion of DOHRC discharges among Blacks may be explained by the concentration of Blacks in low-income central cities with less access to dental care.ConclusionThere are significant racial disparities in the ED utilization for DOHRC in Maryland. These disparities reflect the lack of access to dental care due to both cost and geographic limitations. This results in high healthcare costs and ineffective solutions for patients. Addressing oral health disparities will require policy solutions that are targeted to the populations most at need, and action plans that combine community and state level efforts.

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Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States

Cited by 22 publications

References 19 publications

Trends in non‐traumatic dental emergency department use in New York and New Jersey: a look at Medicaid expansion from both sides of the Hudson River

Trends in non‐traumatic dental emergency department use in New York and New Jersey: a look at Medicaid expansion from both sides of the Hudson River

U.S. Emergency Department Admissions for Nontraumatic Dental Conditions for Individuals With Intellectual and Developmental Disabilities

Racial Disparities in Emergency Department Utilization for Dental/Oral Health-Related Conditions in Maryland

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