About Mary Otto
Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.
Toothaches have sent increasing numbers of poor and uninsured people to emergency rooms nationwide, according to a federal report.
In 2009, more than 900,000 emergency department visits and nearly 13,000 hospital inpatient stays were related to dental conditions, according to a statistical brief from the U.S. Department of Human Services’ Agency for Healthcare Research and Quality.
Between 2006 and 2009, the incidence of emergency department visits for patients seeking dental treatment increased by 16 percent, rising from 874,000 to 936,432 visits, the report also found.
Dental cavities was the first-listed diagnosis, named in 42 percent of the ED visits. Dental abscesses were identified as the cause of 37 percent of the visits. Dental abscesses were the principal diagnosis for 62 percent of the dental-related inpatient stays, according to the report.
Uninsured people, Medicaid beneficiaries and the young were most likely to make dental-related emergency department visits. The visit rates were far more common in rural areas where dentists are often scarce.
“Patients that are going to the ED [for dental care] are totally different from the general ED population,” Ernest Moy, M.D., a medical officer at AHRQ’s Center for Quality Improvement and Patient Safety, told Rob Goszkowski, who wrote about the report for DrBicuspid.com.
“About half of all ED visits are from the elderly, 65 and older, but this is a much, much younger group. The peak age we found in terms of rates of use of the ED [for dental] was 25 to 29, a group that generally doesn’t use the ED that much.”
The findings are to be included the Congressionally mandated National Healthcare Quality and Disparities Reports which inform legislators about the overall quality of health care in the United States, as well as disparities in care, Moy told DrBicuspid.com.
“Many of our products target state policymakers,” he added. “It helps them understand areas where their state is strong and others where problems need to be addressed.”
The findings come out of the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project (HCUP), a group of health care databases developed through federal, state and industry collaboration. The databases represent the combined data collection efforts of state data organizations, hospital associations, private data organizations, and the federal government and are intended as a national information resource of patient-level health care data.
According to the HHS, HCUP includes the largest collection of longitudinal hospital care data in the United States. The databases enable research on a broad range of health policy issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels.
Get more information about HCUP’s Nationwide Emergency Department Sample.
The findings of the federal report echo those contained in another study released by the Pew Center on the States. “A Costly Dental Destination: Hospital Care Means States Pay Dearly” found that financially stressed states have been required to bear the cost of expensive emergency treatment for decay, abscesses and other dental ailments.
The Pew study, which estimated that preventable dental conditions were the primary reason for 830,590 emergency department visits by Americans in 2009, concluded that states could reduce hospital visits, strengthen oral health and reduce their costs by making modest investments to improve access to preventive care.
The philanthropy attributed the increase in hospital visits to the difficulty that disadvantaged people face in getting preventive care from dentists, noting that in 2009, 56 percent of Medicaid-enrolled children did not receive dental care — not even a routine exam.
“The fact that so many Americans go to hospitals for dental care shows the delivery system is failing,” said Shelly Gehshan, director of the Pew Children’s Dental Campaign.
“The care provided in an ER is much more expensive, and it generally doesn’t solve dental problems. Most hospital ERs are not staffed with dentists and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues.”
