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Dental Services in the Emergency Department December 12, 2012. Improving the Health and Well-Being of North Carolinians. Scope of the Problem. Pew Report: .

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Dental Services in the Emergency Department

December 12, 2012

Improving the Health and Well-Being of North Carolinians

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Pew Report:

  • 1997: 62,000 emergency dental visits by Medicaid enrollees in North Carolina that could have been avoided if these patients had received preventive care from a dentist.
  • 2009: >69,000 ER visits to North Carolina hospitals due primarily to disorders of the teeth or jaw. The 10th most common reason for emergency trips in the state.
  • http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/Reports/State_policy/Pew_Report_A_Costly_Dental_Destination.pdf
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National Findings

  • 936,000 ED visits; 13,000 admissions for dental in 2009
    • 16% increase from 2006
  • 25-29 yo largest age demographic
  • Payer Mix:
  • 40% uninsured (vs 17% of all ED visits)
    • 30% Medicaid (vs. 25%)
    • 19% private insurance (vs. 33%)
    • Rural populations visited at rates twice that of urban (480 per 100,000 vs 217 per 100,000)
    • Accessibility of dental workforce a driving factor
  • Ernest Moy, U.S. Agency for Healthcare Research and Quality (AHRQ). From databases for EDs in 29 states.
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Local Findings

  • 1,013 visits with a dental complaint (1.3% of all visits) July 2010- June 2011. 4 resulted in admission
  • Mean patient age of 32
  • 61% self-pay (vs. 22% all ED visits); 11% private (medical)
  • 97% treated and released; 10% dental procedure performed
  • 81% opiate at discharge; 69% antibiotic at discharge
  • No evidence based on days of week/time of day that patients presented when dental offices were closed
  • Michael Hocker et al: NCMJ: Dental Visits to a North Carolina Emergency Departmenthttp://www.ncmedicaljournal.com/wp-content/uploads/2012/09/NCMJ_73502_FINAL.pdf
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Partnerships to improve access

  • Blue Ridge Community Health Center & Pardee Hospital, Hendersonville, NC
  • Traci Spence Director of Operations, BRCHS 828.692.4289 Ext. 2460 tspence@brchs.com