248257 Characteristics of Pediatric Patients Receiving In-Patient Dental Procedures in Children's and General Hospitals: An analysis of national data

Monday, October 31, 2011

Kari Hexem, MPH , School of Dentistry, University of Pennsylvania, Philadelphia, PA
Chris Feudtner, MD PhD MPH , Center for Pediatric Clinical Effectiveness and PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA
Dingwei Dai, PhD , Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA
Jane Kavanagh, BA , PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
Rochelle Lindemeyer, DMD , Department of Pediatric Dentistry, Children's Hospital of Philadelphia, Philadelphia, PA
Andres Pinto, DMD MPH , School of Dentistry, University of Pennsylvania, Philadelphia, PA
Background: Both children's and general hospitals perform in-patient dental procedures. Despite the prevalence of these procedures, demographic and clinical characteristics of patients have not been well described. Method: The Kids' Inpatient Database is a nationally representative sample of administrative hospital discharge reports containing data on procedures, diagnoses, and characteristics of patients and hospitals. We identified hospitalizations of children between 1 and 17 years of age with at least one dental procedure (using ICD-9 codes) performed in 1997, 2000, 2003, and 2006 (N=16,148). Results: Adjusting for child age, admission type, and the number of diagnoses, the odds of receiving a restoration in a children's hospital were 2.14 (95% CI: 1.66-2.76). The odds of receiving a restoration through a direct admission were 4.38 (95% CI: 3.52-5.45). In both children's and general hospitals, for both emergency room and direct admissions, children 1-5 years were more likely to receive extractions (p< 0.05) and restorations (p<0.01) than older children. After adjusting for patient age, income zip code, number of diagnoses, hospital type, and admission type, children with Medicaid were more likely to receive restorations (OR 1.70, 95% CI: 1.42-2.03) and extractions (OR 1.39, 95% CI: 1.23-1.58), and less likely to receive surgical extractions (OR 0.70, 95% CI: 0.62-0.80). Conclusions: The increased likelihood of in-patient extractions and restorations for young pediatric patients and those with Medicaid may suggest lack of access to outpatient dental care. Further research is necessary to understand why children of all ages with Medicaid are less likely to receive surgical extractions.

Learning Areas:
Epidemiology

Learning Objectives:
Describe the prevalence of pediatric in-patient dental procedures in children's and general hospitals. Compare dental procedures in patients who have emergency room vs. direct admissions. Summarize the demographic and clinical characteristics of children receiving in-patient dental procedures. Identify strengths and weaknesses of using hospital administrative databases for dental epidemiological studies.

Keywords: Oral Health, Pediatrics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiological and health services research associate with a MPH in Epidemiology and Biostatistics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.