IADR Abstract Archives
Characteristics of “Superutilizers” of Non-Traumatic Emergency Department Dental Visits
Objectives: The overutilization of emergency departments (EDs) for treatment of non-traumatic dental conditions (NTDCs) imposes a large economic burden on the US health care system. This study evaluated characteristics of “superutilizers” (NTDC ED visit>4 times in one calendar year) in Florida, Wisconsin, New York, Utah, Maryland, Colorado, and Iowa. We investigated costs and charge trends for superutilizers and factors associated with being a superutilizer.
Methods: Data by state and year was obtained from the State Emergency Department Databases (SEDD), including demographic, geographic, diagnosis, cost, and payer information. Descriptive statistics for ED visitor types (superutilizers, NTDC (<4 visits per year), and general (non-NTDC) ED visitors) were evaluated. Multivariable logistic regression was developed to predict the likelihood of becoming a superutilizer based on characteristics at the first NTDC visit (age, sex, race, insurance type, income quartile, ICD-CM-Code group).
Results: Of the 27M ED visitors, 2.34% visited for NTDCs, and 1.29% of NTDC visitors were superutilizers. Superutilizers were more likely to be white and female, consistent with overall ED visitor characteristics. Superutilizers were younger than NTDC and general ED visitors. Black, Hispanic, and individuals who reported an “other” race or whose race was “unknown” were less likely to be superutilizers than white individuals. Superutilizers were most likely to have Medicaid coverage (46.5%), followed by NTDC (37.6%) and general ED visitors (24.2%) Overall, the average cost for superutilizer visits was 2.89 times higher than for NTDC visits and 3.07 times higher than for general ED visits. Florida superutilizers had the highest mean ED visit costs followed by Colorado and Utah. Colorado residents were least likely to be superutilizers.
Conclusions: Expansion of dental services for adults is needed to ensure that they can access timely preventive and restorative services and avoid the burden of dental crisis that requires a visit to the ED.
Methods: Data by state and year was obtained from the State Emergency Department Databases (SEDD), including demographic, geographic, diagnosis, cost, and payer information. Descriptive statistics for ED visitor types (superutilizers, NTDC (<4 visits per year), and general (non-NTDC) ED visitors) were evaluated. Multivariable logistic regression was developed to predict the likelihood of becoming a superutilizer based on characteristics at the first NTDC visit (age, sex, race, insurance type, income quartile, ICD-CM-Code group).
Results: Of the 27M ED visitors, 2.34% visited for NTDCs, and 1.29% of NTDC visitors were superutilizers. Superutilizers were more likely to be white and female, consistent with overall ED visitor characteristics. Superutilizers were younger than NTDC and general ED visitors. Black, Hispanic, and individuals who reported an “other” race or whose race was “unknown” were less likely to be superutilizers than white individuals. Superutilizers were most likely to have Medicaid coverage (46.5%), followed by NTDC (37.6%) and general ED visitors (24.2%) Overall, the average cost for superutilizer visits was 2.89 times higher than for NTDC visits and 3.07 times higher than for general ED visits. Florida superutilizers had the highest mean ED visit costs followed by Colorado and Utah. Colorado residents were least likely to be superutilizers.
Conclusions: Expansion of dental services for adults is needed to ensure that they can access timely preventive and restorative services and avoid the burden of dental crisis that requires a visit to the ED.