Unlocking Dental Care Insights: Nebraska’s ED Use Revealed!
A Growing Public Health Challenge
For over a decade, residents of Nebraska have been making their way to emergency departments (EDs) for non-traumatic dental issues—seeking relief from pain instead of visiting a dentist’s office, where the care is not only more appropriate but also significantly less expensive. Shockingly, 52 out of 93 counties in Nebraska are grappling with a shortage of dental care facilities, and at least 20 counties don’t have a full-time dentist at all. Between 2009 and 2016, an analysis of hospital discharge data revealed a staggering average of 7,982 visits to EDs for non-traumatic dental conditions each year. The financial burden has surged, with the average cost of an ED visit for dental issues skyrocketing from $712 in 2012 to a whopping $1,912 by 2018. To tackle this pressing public health crisis, Nebraska is on a mission to gather more data and develop effective solutions.
Actions Taken
In Nebraska, every visit to an ED is carefully documented, providing a treasure trove of data for the Nebraska Department of Health and Human Services (DHHS). This vast database has become essential in understanding the scope of dental-related ED visits.
To decode this critical data, an oral health epidemiologist from DHHS crafted a definition to identify non-traumatic dental conditions, including patient demographics and the reasons behind these visits. The definition relies on two key components:
- Discharge-diagnostic codes, adhering to the guidelines set by the Association of State and Territorial Dental Directors
- Chief complaints, utilizing primary search terms relevant to dental issues
To ensure the accuracy and depth of this definition, epidemiologists meticulously reviewed 500 random records that matched the criteria, categorizing them as related, unclear, or unrelated to non-traumatic dental conditions. They also examined data from 40% of Nebraska’s EDs, painting a clearer picture of this issue.
Outcomes of the Investigation
By applying their refined definition to Nebraska ED data, the researchers unearthed a staggering 10,433 visits to EDs between January 2017 and December 2018 that were potentially related to non-traumatic dental conditions. Upon closer examination, a significant 85% of these visits were indeed linked to dental issues, while 12% remained unclear, and only 3% were unrelated. The analysis revealed that the majority of these visits involved females (55%), particularly those aged 26-45 years (47%), and urban residents (82%). Alarmingly, about 93% of the patients who made these ED visits were simply discharged back home without receiving the comprehensive dental care they urgently needed. The implications are clear: reliance on EDs for dental care not only poses a public health concern but also places a considerable economic strain on the healthcare system in Nebraska. These vital findings are now shaping policies and interventions aimed at facilitating access to proper dental care, ensuring that no one has to resort to an ED for relief.
Resources
Lead Author: Pankti Parmar
Contact: Dr. Charles F. Craft, State Dental Health Director
Nebraska Department of Health and Human Services
Email: [email protected]
Centers for Disease Control and Prevention
Office of Public Health Data, Surveillance, and Technology
Detect and Monitor Division
www.cdc.gov/nssp
We express our gratitude to Pankti Parmar for her invaluable contributions to this report. For further inquiries, feel free to reach out to Dr. Craft at [email protected].
The insights presented in this success story reflect the perspectives of the authors and do not necessarily align with the official stance of the National Syndromic Surveillance Program or the Centers for Disease Control and Prevention.
