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

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.