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Medications Prescribed in Emergency Departments for Non-Traumatic Dental Conditio

急诊科针对非外伤性牙科疾病开出的药物

基本信息

批准号：
7981383
负责人：
Christopher Okunseri
金额：
$ 31.07万
依托单位：
MARQUETTE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2013-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7981383
关键词：
Accident and Emergency department Address Adult Analgesics Antibiotics Attention Caring Characteristics Child Clinical Code Communities Continuity of Patient Care Data Data Set Databases Dental Dental Care Dental Offices Dental Schools Development Diagnosis Disease Drug Formulations Ethnic Origin Fracture Goals Guidelines Health Care Costs Health Personnel Health Professional Healthcare Hospitals ICD-9-CM Improve Access Insurance International Classification of Diseases Intervention Knowledge Life Logistic Regressions Masks Measures Medical Minority Groups Modeling Modification Narcotics National Ambulatory Medical Care Survey Nature Oral health Outcome Ownership Patients Pharmaceutical Preparations Physicians Policies Population Group Population Study Postoperative Pain Prevalence Primary Health Care Provider Public Health Race Research Research Methodology Research Personnel Running Services Surveys Target Populations Training United States United States National Center for Health Statistics Visit base cancer pain career cost cost effective demographics graduate student innovation meetings novel programs public health relevance racial and ethnic disparities trend

项目摘要

DESCRIPTION (provided by applicant): There is a growing attention paid by policymakers and health care researchers to the use of emergency departments (ED) for the provision of primary care services because of the continuous increase in medical and dental healthcare cost in the United States. Most patients present to ED with non-traumatic dental conditions (NTDC) and non-urgent medical conditions based on medical criteria. ED use for NTDC visits is a growing dental public health concern that requires urgent research attention. NTDC visits to ED have cost, practice, and program implications and is a potential reason for overcrowding at EDs. However, not enough is known about the population groups and treatments received by these patients at the ED for NTDC visits. NTDCs are best treated at dental offices were definitive and continuity of care can be provided. The overall goal of this project is to address the gap in knowledge related to prescription medications for NTDC visits at EDs and to explore whether racial/ethnic disparities exist in prescribing practices. The specific aims of this study are: (1) to estimate the prevalence and trend of prescription medication use for NTDC visits at EDs from 1996 to 2006. (2) to determine patient factors, provider types, hospital/ED, and geographic characteristics associated with the receipt of prescription medications for NTDC visits from 1996 to 2006. (3) to determine the rates of use of prescription medication for NTDC visits based on physician diagnosis codes, and to specifically evaluate the influence of patients' race/ethnicity on the likelihood of receiving similar prescription for the same physician diagnosis codes. The database for the proposed study, the 1996-2006 National Hospital Ambulatory Medical Care Survey (NHAMCS), is the longest continuously running nationally representative survey of ED utilization maintained by the National Center for Health Statistics. Data from NHAMCS provides an extremely rich set of measures on key patient demographics, geographic and hospital/ED characteristics, and provider Information. Access to the database provides a unique opportunity to examine medication prescription practices from 1996 to 2006 to patients presenting to ED for NTDC visits and whether disparities exists. The study population will include children and adults in the database with assigned International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code by ED healthcare providers that meet the criteria for NTDC visits. Logistic regression models will be fit to determine outcome variables associated with other covariates. The findings from the proposed study would serve as a starting point for the development of data-driven program and policy interventions that can be used to improve access to dental care and reduce oral health care disparities, if they exist. Findings from the study will be used to inform the development of prescription medication treatment guidelines for managing patients presenting to ED for NTDC visits in situation where it is unavoidable. In addition, the project provides the opportunity to build research capacity within the dental school and to train dental and graduate students in research methods for potential careers in research. PUBLIC HEALTH RELEVANCE: Identifying the different population groups and the medications prescribed for NTDC visits at EDs is important for dental public health programming. Dental public health professionals and stakeholders are able to use this information to development appropriate intervention strategies including the formulation of an appropriate national medication guideline for NTDC visits at EDs, where it is unavoidable.

描述（由申请人提供）：由于美国的医疗和牙科保健费用不断增加，政策制定者和医疗保健研究人员越来越关注使用急诊室（ED）提供初级保健服务。根据医疗标准，大多数患者因非创伤性牙科疾病 (NTDC) 和非紧急医疗状况而到急诊科就诊。 NTDC 就诊中使用 ED 是一个日益严重的牙科公共卫生问题，需要紧急研究关注。 NTDC 到急诊室就诊会产生成本、实践和项目影响，也是导致急诊室过度拥挤的一个潜在原因。然而，对于 NTDC 就诊的人群和这些患者在 ED 接受的治疗了解不够。 NTDC 最好在牙科诊所接受治疗，前提是确定并能提供连续性护理。该项目的总体目标是解决 NTDC 到急诊科就诊的处方药相关知识差距，并探讨处方实践中是否存在种族/民族差异。本研究的具体目的是：(1) 估计 1996 年至 2006 年期间 NTDC 就诊时处方药使用的流行率和趋势。(2) 确定 1996 年至 2006 年间与 NTDC 就诊时接受处方药相关的患者因素、提供者类型、医院/急诊室和地理特征。(3) 根据医生诊断确定 NTDC 就诊时处方药的使用率代码，并具体评估患者的种族/族裔对接受相同医生诊断代码的类似处方的可能性的影响。本研究的数据库是 1996-2006 年全国医院门诊医疗调查 (NHAMCS)，它是由国家卫生统计中心维护的持续时间最长的全国代表性的急诊室利用率调查。来自 NHAMCS 的数据提供了关于关键患者人口统计、地理和医院/急诊室特征以及提供者信息的极其丰富的衡量标准。访问该数据库提供了一个独特的机会，可以检查 1996 年至 2006 年向 ED 进行 NTDC 就诊的患者的药物处方实践以及是否存在差异。研究人群将包括数据库中的儿童和成人，并由符合 NTDC 就诊标准的 ED 医疗保健提供者指定的国际疾病分类第 9 版临床修改 (ICD-9-CM) 代码。逻辑回归模型将适合确定与其他协变量相关的结果变量。拟议研究的结果将作为制定数据驱动计划和政策干预措施的起点，可用于改善获得牙科保健的机会并减少口腔保健差异（如果存在）。该研究的结果将用于指导处方药治疗指南的制定，以管理在不可避免的情况下前往急诊科接受 NTDC 就诊的患者。此外，该项目还提供了在牙科学院内建立研究能力的机会，并对牙科学生和研究生进行研究方法方面的培训，以从事潜在的研究职业。公共卫生相关性：确定不同的人群以及 NTDC 在急诊室就诊时开出的药物对于牙科公共卫生规划非常重要。牙科公共卫生专业人员和利益相关者能够利用这些信息来制定适当的干预策略，包括为不可避免的 NTDC 到急诊室就诊制定适当的国家用药指南。