Trends in dental‐related use of hospital emergency departments in Florida

Abstract

Study objective The inability to access regular dental care may lead to care seeking at hospital emergency departments (EDs). However, EDs generally are not equipped or staffed to provide definitive dental services. This study examined trends and patterns of hospital ED use for dental-related reasons in Florida, a large, diverse state with serious barriers to accessing dental care. Methods Data for this study were drawn from ambulatory ED discharge records compiled by Florida’s Agency for Health Care Administration for 2005–2014. Visits for dental-related reasons in Florida were defined by the patient’s reported reason for seeking care or the ED physician’s primary diagnosis using ICD-9-CM codes. We calculated frequencies, age-specific and age-adjusted rates per 100,000 population, and secular trends in dental-related ED visits and their associated charges. Results The number of dental-related visits to Florida EDs increased each year, from 104,642 in 2005 to 163,900 in 2014; the age-adjusted rate increased by 43.6%. Total charges for dental-related ED visits in Florida increased more than three-fold during this time period, from $47.7 million in 2005 to $193.4 million in 2014 (adjusted for inflation). The primary payers for dental-related ED visits in 2014 were Medicaid (38%), self-pay (38%), commercial insurance (11%), Medicare (8%), and other (5%). Conclusions Dental-related visits to hospital EDs in Florida have increased substantially during the past decade, as have their associated charges. Most patients did not receive definitive oral health care in EDs, and this trend represents an increasingly inefficient use of health care system resources.

Hospital use for non‐traumatic dental conditions among older adults in Florida

“…Florida EDs are one of the most expensive sources of care for dental problems. Total charges for dental‐related visits increased from $47.7 million in 2005 to $234.4 million in 2014 . Florida had low Medicaid fee‐for‐service reimbursement rates, and just 28.9% of dentists participated in Medicaid in 2017.…”

“…Florida had low Medicaid fee‐for‐service reimbursement rates, and just 28.9% of dentists participated in Medicaid in 2017. One‐third of Florida's ED dental visits were paid by Florida Medicaid …”

“…6 The number of visits to Florida's emergency departments (EDs) for NTDCs increased every year between 2005 (104 646 visits) and 2014 (163 906 visits) and age-adjusted rates increased by 44% during that time, from 630.44 per 100 000 population to 905.14 per 100 000. 7 Florida EDs are one of the most expensive sources of care for dental problems. Total charges for dental-related visits increased from $47.7 million in 2005 to $234.4 million in 2014.…”

“…Total charges for dental-related visits increased from $47.7 million in 2005 to $234.4 million in 2014. 7 Florida had low Medicaid fee-for-service reimbursement rates, and just 28.9% of dentists participated in Medicaid in 2017. One-third of Florida's ED dental visits were paid by Florida Medicaid.…”

“…One-third of Florida's ED dental visits were paid by Florida Medicaid. 7 The number of hospital inpatient admissions for NTDCs in Florida increased each year from 1808 in 2006 to 3542 in 2016, a 96% increase. 5 The age-adjusted admissions rate increased by 71% during that period from 13.28 per 100 000 population to 22.13 per 100 000, and total charges associated with those admissions increased from $46.1 million to $166.5 million.…”