Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care survey.
Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care survey.
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DOI：
10.2147/ccide.s49191
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Szabo A
中科院分区：
文献类型：
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作者：
Okunseri C;Okunseri E;Fischer MC;Sadeghi SN;Xiang Q;Szabo A
目的：探讨非创伤性牙科疾病(NTDC)相关急诊科(ED)就诊率是否在牙科诊所的典型工作时间较高，而在夜间较低，以及相关因素。我们分析了1997年至2007年全国医院非卧床医疗护理调查的数据，使用调查设计调整后的多变量二分和多分Logistic回归来确定预测因素对特定结果变量的影响。总体而言，共确定了4726条意见，涉及1640万次与NTDC相关的ED访问。与NTDC相关的急诊率有显著差异，非工作时间的就诊率高出40%-50%，周末的就诊率比总平均每小时170次就诊率高出20%。与19~33岁人群相比，18岁及以下人群在非工作时间就诊急诊的相对率显著高于非工作时间组[相对率比=1.6~1.8]，而73岁及以上人群非工作时间就诊相对率较低(P=0.0005)。与有私人保险的患者相比，医疗补助和自费患者在非工作时间和夜间就诊的相对比率显著较低(RRR=0.60.7，总体P<；0.0003)。有牙科原因的患者在夜间就诊的比例过高(RRR=1.3；总体P=0.04)。非工作时间和周末去急诊室就诊的比率较高，且与年龄、就诊原因和付款人类型显著相关。
To determine whether the rates of nontraumatic dental condition (NTDC)-related emergency department (ED) visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors. We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables. Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%–50% higher rates during nonworking hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19–33 year olds, subjects < 18 years old had significantly higher relative rates of NTDC-related ED visits during nonworking hours [relative rate ratio (RRR) = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005). Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P < 0.0003). Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04). NTDC-related visits to ED occurred at a higher rate during nonworking hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type.