Hospital Usage for Oral and Dental Conditions in Hawaii: A Cross-sectional Study Using the 2021 Hawaii Statewide Hospital Data

Overview

Journal J Public Health Dent

Specialties Dentistry
Public Health

Date 2024 Mar 21

PMID 38509055

Authors

Masako Matsunaga

Patrick Donnelly

John J Chen

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits.

Methods: This was a cross-sectional study of the 2021 Hawaii Statewide Hospital data. We identified records indicating ED usage and a primary diagnosis of non-traumatic dental conditions (NTDC) and other oral dental conditions (OODC). Descriptive analyses of ED visits for NTDC and OODC were performed to identify vulnerable individuals based on age, sex, race/ethnicity, primary source of payment, county of residence, and total charges per hospital record. A multivariable negative binomial regression model included age, sex, and county of residence was used to obtain adjusted rate ratios (aRR) and 95% confidence intervals (CI) of ED visits for NTDC.

Results: Among hospital records with diagnoses for oral or dental conditions (n = 12,336), 97% indicated ED, of which half had an NTDC diagnosis, and the remaining half had an OODC diagnosis. Distinct differences in the characteristics of ED visits were observed between NTDC and OODC. The median total charges per record indicating ED for NTDC and OODC were $1439 and $2439, respectively. A higher rate of ED visits for NTDC was found for those aged 21-44 (aRR [95%CI] = 3.02 [2.41, 3.80], reference: 0-9 years) and those living in a less populous county (Hawaii: 1.73 [1.43, 2.07]; Kauai: 1.78 [1.45, 2.19], reference: Honolulu).

Conclusions: Continued effort to improve dental health is required to reduce ED visits for oral and dental conditions among Hawaii residents, especially for vulnerable individuals.

References

Heggie C, Gallichan N, Gartshore L, Hartshorn S, Messahel S, Clark V . Traumatic and non-traumatic dental presentations to the paediatric emergency departments of two UK children's hospitals: A multi-centre evaluation. Int J Paediatr Dent. 2021; 32(1):90-100. DOI: 10.1111/ipd.12796. View

Tomar S, Carden D, Dodd V, Catalanotto F, Herndon J . Trends in dental-related use of hospital emergency departments in Florida. J Public Health Dent. 2016; 76(3):249-57. PMC: 5010510. DOI: 10.1111/jphd.12158. View

Darling B, Singhal A, Kanellis M . Emergency department visits and revisits for nontraumatic dental conditions in Iowa. J Public Health Dent. 2015; 76(2):122-8. DOI: 10.1111/jphd.12120. View

Okunseri C, Vanevenhoven R, Chelius T, Beyer K, Okunseri E, Lobb W . Travel distances by Wisconsin Medicaid enrollees who visit emergency departments for dental care. J Public Health Dent. 2016; 76(3):213-9. PMC: 4956604. DOI: 10.1111/jphd.12138. View

Amen T, Kim I, Peters G, Gutierrez-Sacristan A, Palmer N, Simon L . Emergency department visits for dental problems among adults with private dental insurance: A national observational study. Am J Emerg Med. 2021; 44:166-170. DOI: 10.1016/j.ajem.2021.02.001. View

Oh J, Leonard L . Hospital emergency department visits for non-traumatic oral health conditions among Rhode Island adults age 21-64 years, 2006-2010. Med Health R I. 2013; 95(11):367-9. View

Berger T, Kenny D, Casas M, Barrett E, Lawrence H . Effects of severe dentoalveolar trauma on the quality-of-life of children and parents. Dent Traumatol. 2009; 25(5):462-9. DOI: 10.1111/j.1600-9657.2009.00809.x. View

Hong L, Liu Y, Hottel T, Hoff G, Cai J . Neighborhood socio-economic context and emergency department visits for dental care in a U.S. Midwestern metropolis. Public Health. 2015; 129(3):252-7. DOI: 10.1016/j.puhe.2014.11.014. View

Allareddy V, Rampa S, Lee M, Allareddy V, Nalliah R . Hospital-based emergency department visits involving dental conditions: profile and predictors of poor outcomes and resource utilization. J Am Dent Assoc. 2014; 145(4):331-7. DOI: 10.14219/jada.2014.7. View

10.

Okunseri C, Okunseri E, Thorpe J, Xiang Q, Szabo A . Patient characteristics and trends in nontraumatic dental condition visits to emergency departments in the United States. Clin Cosmet Investig Dent. 2013; 4:1-7. PMC: 3652363. DOI: 10.2147/CCIDEN.S28168. View

11.

Bahdila D, Aldosari M, Cordes J, Klevens R . Emergency department visits for infectious oral conditions in Massachusetts, 2014 through 2018. J Am Dent Assoc. 2021; 152(8):604-612.e3. DOI: 10.1016/j.adaj.2021.03.014. View

12.

Magno M, Jural L, Nogueira A, Lenzi M, Pithon M, Maia L . Impact of crown fracture treatment on oral health-related quality of life of children, adolescents, and their families: A prospective clinical study. Int J Paediatr Dent. 2018; 29(1):86-93. DOI: 10.1111/ipd.12437. View

13.

Hom J, Burgette L, Lee J . The effect of North Carolina hospital payor mix on dental-related pediatric emergency room utilization. J Public Health Dent. 2013; 73(4):289-96. PMC: 4581717. DOI: 10.1111/jphd.12025. View

14.

Matsunaga M, Chen J, Donnelly P, Fok C, Partika N . Emergency Room Visits with a Non-Traumatic Dental-Related Diagnosis in Hawaii, 2016-2020. Int J Environ Res Public Health. 2022; 19(5). PMC: 8910124. DOI: 10.3390/ijerph19053073. View

15.

Kelekar U, Naavaal S . Dental visits and associated emergency department-charges in the United States: Nationwide Emergency Department Sample, 2014. J Am Dent Assoc. 2019; 150(4):305-312.e1. DOI: 10.1016/j.adaj.2018.11.021. View

16.

Born C, Jackson T, Koroluk L, Divaris K . Traumatic dental injuries in preschool-age children: Prevalence and risk factors. Clin Exp Dent Res. 2019; 5(2):151-159. PMC: 6483041. DOI: 10.1002/cre2.165. View

17.

Ishikawa K, Matsunaga M, Ahn H, Siriwardhana C, Chen J . Age and Sex Distributions of 31 Common Racial Groups in Hawai'i: A Shiny Web Application. Hawaii J Health Soc Welf. 2023; 82(10 Suppl 1):89-96. PMC: 10612410. View

18.

Azadani E, Evans J, Peng J, McTigue D, Townsend J . Risk of concomitant traumatic brain injuries in children with traumatic dental injuries in a pediatric emergency department: A case-control study. J Am Dent Assoc. 2023; 154(9):805-813.e1. DOI: 10.1016/j.adaj.2023.05.011. View

19.

Matsunaga M, Ishikawa K, Siriwardhana C, Ahn H, Chen J . Stepwise Proportional Weighting Algorithm for Single-Race Population Estimation Using Hawai'i Census Data. Hawaii J Health Soc Welf. 2023; 82(10 Suppl 1):97-103. PMC: 10612413. View

20.

Azadani E, Townsend J, Peng J, Wheeler K, Xiang H . The association between traumatic dental and brain injuries in American children. Dent Traumatol. 2020; 37(1):114-122. DOI: 10.1111/edt.12611. View