Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid.
Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid.
复制标题
威斯康星州医疗补助计划中非创伤性牙科疾病到急诊科就诊后的牙科服务利用模式。
DOI：
10.1111/j.1752-7325.2012.00364.x
复制
发表时间：
2014
影响因子：
2.3
通讯作者：
Okunseri,Christopher
中科院分区：
文献类型：
--
作者：
Pajewski,NicholasM;Okunseri,Christopher
目的：研究威斯康星州成年医疗补助参保者在非创伤性牙病（NTDC）就诊急诊科（ED）后牙科服务的利用模式。方法：这是一项回顾性的观察性研究，对来自威斯康星州医疗补助评估和决策支持数据库（2001 - 2009）的非传染性疾病患者到急诊科和牙科服务就诊的索赔进行研究。我们使用竞争风险模型来预测返回急诊科与获得牙医随访护理的概率。结果：我们观察到非传染性疾病患者到急诊科就诊的比率增加了43%，其中大部分增长发生在2001年至2005年。在NTDC就诊后的30天内，约29.6%的参保者会首先去看牙医，而约9.9%的参保者会再次去看牙医。青壮年至中年人（18岁至50岁以下）和居住在牙科服务提供者供应较少的县的参保者更有可能在NTDC就诊后再次去看牙医。在急诊科就诊后第一次去牙科诊所的患者中，37.6%的人在这次就诊时进行了拔牙。结论：几乎五分之一的成年医疗补助登记者将在之前的NTDC访问后返回ED。为这些人提供明确的护理似乎主要包括拔牙。
Objectives:To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition (NTDC) visits to the emergency department (ED).Methods:This is a retrospective, observational study of claims for NTDC visits to the ED and dental service encounters from the Wisconsin Medicaid Evaluation and Decision Support database (2001‐2009). We used competing risk models to predict probabilities of returning to the ED versus obtaining follow‐up care from a dentist.Results:We observed a 43 percent increase in the rate of NTDC visits to the ED, with most of this increase occurring from 2001 to 2005. Within 30 days of an NTDC visit to the ED, ∼29.6 percent of enrollees will first visit a dentist office, while ∼9.9 percent will return to the ED. Young to middle‐aged adults (18 to <50 years) and enrollees living in counties with a lower supply of dental providers were more likely to return to the ED following a NTDC visit. Among the enrollees that first visited a dental office following an ED visit, 37.6 percent had an extraction performed at this visit.Conclusions:Almost one in five adult Medicaid enrollees will subsequently return to the ED following a previous NTDC visit. The provision of definitive care for these individuals appears to primarily consist of extractions.