Emergency Department as a Main Source of Preventative Dental Care : An Analysis of New Jersey State Emergency Department Discharge Data from 2008 to 2011

Barriers to dental care often results in patients using Emergency Departments for dental treatment. This study is intended to examine:1)the characteristics of patients using the ED for primary dental care to identify the underserved populations, and 2) utilization trends in recent years. Dental ACSC (Ambulatory Care Sensitive Conditions) visits were identified in NEW JERSEY Hospital Emergency Department Discharge data 2008-2011. Race/ethnicity, gender, age, payer and total charges for ED dental patients were examined, and compared to those of entire inpatient group.

The results show that both frequencies and total charges for ED dental visits increased steadily by 8.5% and 54% respectively from 2008-2011. The average charge per ED dental visit in 2011 was $1143, representing a 45 % increase over 2008 charges. The 25-44 age group made up 51.5% of all ED dental patients, which was significantly higher (z=308,p<0.0001) than that of inpatients in that age group(20.9%) indicating a lack of dental coverage in federal/state assisted programs for this age group. The rate of self/charity(45.5%) in ED dental patients was 5 times higher than that of all inpatients(z=549,p<0.0001), and Medicaid (21.1%) 3 times(z=199.7,p<.0001). These findings may be indicative of the disparity between medical and dental coverage in federal/state funded insurance programs. The rate of blacks (34.1%) in ED dental patients was higher by 2.3 times than that in all inpatients(z=81.1, p<0.0001). The distinct demographic profiles of ED dental patients and an increasing trend of utilization cost may call for the provision of cost effective alternative programs for these vulnerable populations.