Access to oral health care is a critical need for the adult Medicaid population. Following the 2014 expansion of Medicaid eligibility in Kentucky, millions of adults became eligible to receive dental benefits. We examined the impact of the expansion on adult Medicaid enrollees' use of hospital emergency departments (EDs) for conditions related to dental or oral health in the period 2010-14. Based on our analysis of data for Kentucky from the State Emergency Department Databases, we found that the rate of discharges for these conditions from the ED increased significantly, from 1,833 per 100,000 population in 2013 to 5,635 in 2014. Adults covered by Medicaid who used the ED for treatment of oral health conditions in 2014 had high levels of chronic comorbidities and were more likely to be male and nonwhite than those in earlier years. To avoid costly and inappropriate use of the ED, states considering adding an adult Medicaid dental benefit should consider also making changes to assist beneficiaries in obtaining access to the dental health care delivery system.
Childhood obesity is a major public health problem. An association between obesity and dental caries, the most prevalent disease of childhood, has been identified. One explanation for the association is that consumption of sugarsweetened beverages and frequent snacking on carbohydrate-rich foods are common risk factors for development of both obesity and caries.
Some of the characteristics of men, with known risk factors, who were most likely to respond to an invitation to be screened in a national randomized clinical trial to prevent heart disease were determined in 18,872 men, 35-57 years of age, members of the Kaiser Foundation Health Plan of Oregon. Demographic characteristics and risk factor variables (blood pressure, blood cholesterol, and cigarette smoking levels) were abstracted from medical records.The men were ranked high priority or low priority according to level of risk. All age-eligible men in the health plan received at least one invitation to be screened, with high-priority men receiving more in-
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