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, Nadia; Brow, Avery; Tranby, Eric; Badner, Victor

doi:10.1111/jphd.12343

Cited by 7 publications

(11 citation statements)

References 15 publications

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“…There was a 9.7 percentage point decrease in ED visits for non-traumatic dental conditions between 2008 and 2014 in Minnesota [37]. Similarly, the percentage of ED discharges with non-traumatic dental conditions decreased in New York and New Jersey from 2010 to 2014 [39]. The percentage of the ED discharges for dental or oral conditions that occurred among the uninsured decreased from 56.8% in 2013 to 20.5% in 2014 in Kentucky [35] as well as in New Jersey and New York from 2010 to 2014 [39].…”

Section: Emergency Department (Ed) Visitsmentioning

confidence: 95%

“…The percentage of the ED discharges for dental or oral conditions that occurred among the uninsured decreased from 56.8% in 2013 to 20.5% in 2014 in Kentucky [35] as well as in New Jersey and New York from 2010 to 2014 [39]. However, the percentage of ED discharges for a dental or oral condition that was covered by Medicaid increased in Kentucky (17.6% in 2013 and 49.7% in 2014) [35] as well as in New Jersey [39]. Among Medicaid enrollees, the percentage of those diagnosed with dental or oral health conditions increased from 2.7% in 2013 to 3.7% in 2014 [35].…”

Section: Emergency Department (Ed) Visitsmentioning

confidence: 97%

“…There were five studies that examined the impact of the ACA on the use of EDs [35][36][37][38][39]. There was an overall increase in ED visits for dental conditions from 2012 to 2014, but there was a decrease in ED visits for dental conditions in states that expanded Medicaid offering dental benefits [38].…”

Section: Emergency Department (Ed) Visitsmentioning

confidence: 99%

“…Similarly, the percentage of ED discharges with non-traumatic dental conditions decreased in New York and New Jersey from 2010 to 2014 [39]. The percentage of the ED discharges for dental or oral conditions that occurred among the uninsured decreased from 56.8% in 2013 to 20.5% in 2014 in Kentucky [35] as well as in New Jersey and New York from 2010 to 2014 [39]. However, the percentage of ED discharges for a dental or oral condition that was covered by Medicaid increased in Kentucky (17.6% in 2013 and 49.7% in 2014) [35] as well as in New Jersey [39].…”

Section: Emergency Department (Ed) Visitsmentioning

confidence: 99%

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The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review

Song

Kim

Tomar

et al. 2021

IJERPH

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The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless adults. The implementation of the ACA was not directly associated with dental insurance coverage among people in the U.S. However, results suggest positive spillover effects of the ACA on dental care coverage and utilization by people in the national level dataset.

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Section: Emergency Department (Ed) Visitsmentioning

confidence: 95%

Section: Emergency Department (Ed) Visitsmentioning

confidence: 97%

Section: Emergency Department (Ed) Visitsmentioning

confidence: 99%

Section: Emergency Department (Ed) Visitsmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review

Song

Kim

Tomar

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Restriction of public dental benefits was associated with increased NTDC ED visits in California, 64 Illinois, 65 Maryland, 66 Oregon, 67 and Massachusetts, 68 but not in an Arizona county. 69 Expanding Medicaid dental coverage was associated with increased ED visits for NTDCs in Kentucky, 70 Minnesota, 71 New Jersey 72 and Oregon, 73 but was associated with decreased visits in Michigan. 74…”

Section: Effect Of Medicaid Expansion and Coverage Restrictionsmentioning

confidence: 99%

Emergency department visits for nontraumatic dental conditions: a systematic literature review

Akinlotan

Ferdinand

2020

J Public Health Dent

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Objective: To summarize the literature on factors associated with emergency department (ED) use for nontraumatic dental conditions (NTDCs). Methods: Following a database search, empirical studies were included if they examined factors associated with ED visits for NTDCs. The factors identified in these studies were further categorized using the Andersen Behavioral Model. Where appropriate, odds ratios (ORs) predicting the likelihood of NTDC ED visits were extracted to obtain summary estimates using random effects models. Results: Sixty-three articles were included. Nontraumatic dental ED visits made up about 2.2 percent of all ED visits. Having public health insurance coverage such as Medicaid [OR = 2.17, 95 percent confidence interval (CI) = 1.79-2.64], and being uninsured (OR = 2.80, 95 percent CI = 2.39-3.39) were predictive of ED visits for NTDCs. Adults were more likely to use the ED for NTDCs compared to children and older adults. Rural adults had increased odds of ED use for NTDCs compared to urban adults (OR = 1.31, 95 percent CI = 1.12-1.52). Among younger children, regular dental care without sealant placement was associated with increased ED use for NTDCs. In the United States, both expansion and restriction of Medicaid dental coverage for adults were associated with increased ED visits for NTDCs. Conclusions: Policy makers and health care providers should address modifiable factors such as accessible dental care for the uninsured, and comprehensive dental coverage for those with public dental benefits. Targeted interventions should focus on young adults, children with special needs, and subpopulations with low socioeconomic status and chronic health conditions.

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Medicaid Managed Care and Pediatric Dental Emergency Department Visits

Baker,

Munnich,

Kranz

2024

JAMA Health Forum

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ImportanceMillions of economically disadvantaged children depend on Medicaid for dental care, with states differing in whether they deliver these benefits using fee-for-service or capitated managed care payment models. However, there is limited research examining the association between managed care and the accessibility of dental services.ObjectiveTo estimate the association between the adoption of managed care for dental services in Florida’s Medicaid program and nontraumatic dental emergency department visits and associated charges.Design, Setting, and ParticipantsThis cohort study used an event-study difference-in-differences design, leveraging Florida Medicaid’s staggered adoption of managed care to examine its association with pediatric nontraumatic dental emergency department visits and associated charges. This study included all Florida emergency department visits from 2010 to 2014 in which the patient was 17 years or younger, the patient was a Florida resident, Medicaid paid for the visit, and a primary or secondary International Classification of Diseases, Ninth Revision, code was used to classify a nontraumatic dental condition. Analyses were conducted between May 2023 and April 2024.ExposureThe county of residence transitioning Medicaid dental services from fee-for-service to a fully capitated managed care program managed by a dental plan.Main Outcomes and MeasuresThe rate of nontraumatic dental emergency department visits per 100 000 pediatric Medicaid enrollees and the associated mean charges per visit. Nontraumatic dental emergency department visits are a well-documented proxy for access to dental care. Data on emergency department visit counts came from the Florida Agency for Health Care Administration. Medicaid population denominators were derived from the American Community Survey’s 5-year estimates.ResultsAmong the 34 414 pediatric nontraumatic dental emergency department visits that met inclusion criteria across Florida’s 67 counties, the mean (SD) age of patients was 8.11 (5.28) years, and 50.8% of patients were male. Of these, 10 087 visits occurred in control counties and 24 327 in treatment counties. Control counties generally had lower rates of NTDC ED visits per 100 000 enrollees compared with treatment counties (123.5 vs 132.7). Over the first 2.5 years of implementation, the adoption of managed care was associated with an 11.3% (95% CI, 4.0%-18.4%; P = .002) increase in nontraumatic dental emergency department visits compared with pre-implementation levels. There was no evidence that the average charge per visit changed.Conclusions and RelevanceIn this cohort study, Florida Medicaid’s adoption of managed care for pediatric dental services was associated with increased emergency department visits for children, which could be associated with decreased access to dental care.

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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

Cited by 7 publications

References 15 publications

The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review

The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review

Emergency department visits for nontraumatic dental conditions: a systematic literature review

Medicaid Managed Care and Pediatric Dental Emergency Department Visits

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