Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community

2018 ◽  
Vol 24 (1) ◽  
pp. 74 ◽  
Author(s):  
Matthew Yap ◽  
Mei-Ruu Kok ◽  
Soniya Nanda ◽  
Alistair Vickery ◽  
David Whyatt
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Dental Health ◽  
Positive Association ◽  
Dental Service ◽  
Dental Services ◽  
Service Accessibility ◽  
Poor Access ◽  
Per Capita ◽  
Dental Conditions

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04–1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88–0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

scholarly journals Dental Expenditure by Household Income in Korea over the Period 2008–2017: A Review of the National Dental Insurance Reform

2021 ◽  
Vol 18 (8) ◽  
pp. 3859
Author(s):  
Hosung Shin ◽  
Han-A Cho ◽  
Bo-Ra Kim
Keyword(s):  
Health Insurance ◽  
Concentration Index ◽  
Dental Health ◽  
Age Groups ◽  
The Elderly ◽  
Dental Service ◽  
Delta Method ◽  
Dental Services ◽  
Insurance Reform ◽  
Health Insurance Reform

Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the ratio of expenditures for dentures and fixed bridges decreased relatively. The concentration index of implant services was basically in favor of the rich, but there was no longer a significant bias favoring the better-off after the reforms. The dental health insurance reform in Korea appears to contribute not only to lowering the ratio of out-of-pocket to total dental expenses per episode in the elderly but also to improving the inequality of dental expenses.

scholarly journals Dental Service Utilization of a Rural Population in Nigeria

2019 ◽  
Vol 4 (2) ◽  
pp. 62-65
Author(s):  
O.O Osadolor ◽  
◽  
E.A Akaji ◽  
U Otakhoigbogie ◽  
H.C Amuta ◽  
...  
Keyword(s):  
Service Utilization ◽  
Dental Care ◽  
Rural Population ◽  
Household Income ◽  
Dental Health ◽  
Health Centre ◽  
Dental Service ◽  
Dental Clinic ◽  
Dental Services ◽  
Socio Demographic Factors

Background: Dental health is often neglected by a vast majority of the population and has contributed to the global burden of oral diseases. Prevention of disease, disability and suffering should be a primary goal of any society that hopes to provide a decent quality of life for its people. Dental care/service utilization is an indispensable facilitator of oral health, as dental caries and gingivitis are preventable with regular access to preventive dental services. Several reasons have been attributed to use and non-use of dental services and include socio-demographic factors such as age, sex, educational attainment, and household income. Objective: To determine dental service utilization of a rural population in South-east Nigeria. Methodology: A cross sectional study of 268 participants was carried out at Ozalla Model Primary Health Centre, Ozalla Health Centre and Umueze Awkunanaw Health Centre located in Ozalla community and Umueze Awkunanaw community respectively. Ethical clearance for this study was sought and obtained. Permission was sought from the head of each health centre, while individual verbal consent was obtained from the respondents before giving out the pretested questionnaire which was interviewer-administered. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 20. Results: 126(47 %) males and 142(53%) females were seen. The age of the participants ranged from 18 - 86 years with a mean age of 32.4 ± 13.3 years. 131(48.9%) were married, 133(49.6%) were single and 4(1.5%) were divorced. 39(14.6%) had only primary level of education, 142(52.6%) secondary, 67(25.0%) tertiary and 21(7.8%) had no formal education. 64(23.9%) had utilized dental service, while 204(76.1%) had not visited a dental clinic (had not utilized dental service). The common reason for dental service utilization was dental pain. The predominant occupation was farming and small scale business/trading. P= 0.038. Conclusion: Dental health was neglected by a vast majority of the participants, The poor utilization of dental service by the respondents could be due to poor awareness, absence of dental insurance, financial constraints , lack of perceived need for dental care, economic difficulties ,socio-demographic factors such as age, sex, educational attainment, and household income. Effort needs to be applied to create better awareness and possibly increase dental clinic attendance. Emphasis should be placed on benefits of utilizing preventive dental services rather than only curative through dental awareness programms.

scholarly journals Two-year supervised tooth brushing program evaluation in preschools in Southern Israel

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Dekel ◽  
S P Zusman ◽  
V Pikovsky ◽  
L Natapov
Keyword(s):  
Preschool Children ◽  
Dental Care ◽  
Dental Health ◽  
Dental Service ◽  
Tooth Brushing ◽  
Favorable Effect ◽  
Caries Experience ◽  
Dental Services ◽  
National Health Insurance Law ◽  
Carious Teeth

Abstract Background Dental care for children was included into National Health Insurance Law in 2010 and eligibility age went up gradually to 18 in 2019, providing universal dental care. As a part of dental care reform, community based preventive School Dental Services were extended to preschool children. School dental service (SDS), funded entirely by the State, was extended to younger ages providing supervised tooth brushing module. The national supervised teeth brushing program (STBP) was first implemented in 2015-2016 amongst 3-4 year old children attending 600 nurseries in Israel. Due to the program’s success, it was gradually extended to more nurseries in low socio economic regions across the country, reaching 2200 settings in 2019. The objective of this study was to assess dental health among preschool children participating in the program during the last two years, comparing to those who did not. Methods Participant and non-participant kindergartens were randomly selected in Jewish and Bedouin Arab towns in the Southern district matched according to SES level. DMFT index measuring mean number of decayed, missing and filled teeth was recorded among preschool 5 years-old children. Results 283 children were examined, 157of them Jewish (86 participants in STBP, 71 non-participants) and 126 Bedouins (59 vs 67 respectively). Mean untreated carious teeth (d) was 1.15 vs 1.8 for Jews and 3.22 vs 3.9 for Bedouins. Percent of treated teeth within total caries experience index (f/dmf) was higher in tooth brushing group: 37% vs. 29% for Jews and 23% vs. 8% for Bedouins. Key messages Supervised tooth brushing shows favorable effect. Less carious teeth and more treated caries were recorded in STBP group.

DENTAL SERVICES

PEDIATRICS ◽  
1953 ◽  
Vol 12 (3S) ◽  
pp. 26-28
Keyword(s):  
Dental Care ◽  
Health Program ◽  
Dental Health ◽  
The United States ◽  
Dental Service ◽  
Minimal Amount ◽  
Major Theme ◽  
Dental Services ◽  
True Relationship

WHEN the Study was first projected, its content was a major theme of discussion. It is of interest that the Study Committee unanimously gave children's dental care a high priority among the items for examination. This decision was significant because pediatricians and general practitioners as a group are not particularly interested or wellinformed in this area of medicine. It may have been their very lack of dental knowledge which promoted this part of the Study. The question might be asked, "Is the over-all health of children correlated in any way with the condition of their teeth?" In one of the state reports, a correlation was made between the quality of medical services and dental facilities but this does not answer the question of the true relationship between dental health and over-all health. However, the Committee felt that dental health is generally accepted as an important item in a health program for children. Although the exact cause of tooth decay is not yet determined, it is known that restoration of cavities prolongs the life of the tooth. Areas of Need The findings of the Study do not tell precisely how much dental care is actually required by children in various sections and communities in the country. However, even without exact information on the amount of dental care needed, it is evident that at present not even a minimal amount of dental service can be offered to every child in the United States. The study of dental facilities for children shows that even states and counties which have the highest service ratings are unable to provide adequately for their entire child population.

scholarly journals Factors Associated with Preventable Emergency Department Visits for Nontraumatic Dental Conditions in the U.S.

2019 ◽  
Vol 16 (19) ◽  
pp. 3671 ◽  
Author(s):  
Pearl C. Kim ◽  
Wenlian Zhou ◽  
Shawn J. McCoy ◽  
Ian K. McDonough ◽  
Betty Burston ◽  
...  
Keyword(s):  
Emergency Department ◽  
Dental Care ◽  
Age Groups ◽  
The United States ◽  
Sociodemographic Factors ◽  
Emergency Department Visits ◽  
Dental Services ◽  
Cross Sectional ◽  
Ed Visits ◽  
Dental Conditions

This study was designed to examine national trends and evaluate social determinants of health that were associated with the provision of dental services in emergency rooms in the United States between 2007 and 2014. A pooled cross-sectional database of emergency department (ED) visits combined the 2007–2014 waves of the Nationwide Emergency Department Sample. A total of 3,761,958 ED visits with dental conditions were extracted and the principal diagnosis was identified. A series of modified Poisson regression models were used to assess the relationship between patient sociodemographic factors and hospital characteristics, and the likelihood of visiting the ED for a nontraumatic dental reason. Unadjusted descriptive results indicated that there was no apparent increase in the percentage of patients who visited an ED with nontraumatic dental conditions (NTDCs) between 2007 and 2014. The greatest users of EDs for NTDCs were among those who were uninsured and Medicaid beneficiaries relative to persons privately insured. ED visitors were more likely to reside in lower socioeconomic areas (when compared with visitors in the top quartile of the income distribution). Patients in all other age groups were more likely to seek care in an ED for NTDCs relative to those 65 years of age or older. Multiple strategies are required to reduce the use of EDs for routine dental care. This approach will require an interprofessional dialogue and solutions that reduce barriers to receiving dental care.

Risk factors of hospital admissions and recurrent emergency department visits among pediatric asthma patients

2020 ◽  
pp. 1011-1015
Author(s):  
Abdullah Aldamigh ◽  
Afaf Alnefisah ◽  
Abdulrahman Almutairi ◽  
Fatima Alturki ◽  
Suhailah Alhtlany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Pediatric Asthma ◽  
Emergency Department Visits ◽  
Asthma Patients

scholarly journals First Surveillance of Violence against Women during COVID-19 Lockdown: Experience from “Niguarda” Hospital in Milan, Italy

2021 ◽  
Vol 18 (7) ◽  
pp. 3801
Author(s):  
Giulio Nittari ◽  
Getu Gamo Sagaro ◽  
Alessandro Feola ◽  
Mattia Scipioni ◽  
Giovanna Ricci ◽  
...  
Keyword(s):  
Emergency Department ◽  
Violence Against Women ◽  
Social Problem ◽  
Medical Records ◽  
Hospital Admissions ◽  
Daily News ◽  
The People ◽  
Notable Increase

Violence against women emerges with tragic regularity in the daily news. It is now an evident trace of a dramatic social problem, the characteristics of which are not attributable to certain economic, cultural, or religious conditions of the people involved but affect indiscriminately, in a unanimous way, our society. The study is a survey about the number of hospital admissions due to episodes attributable to violence against women, recorded by the Niguarda Hospital in Milan in the period 1 March–30 May from 2017 to 2020. This period, in 2020, corresponds to the coronavirus Lockdown in Italy. All the medical records of the Emergency department were reviewed, and the extracted data classified in order to identify the episodes of violence against women and the features of the reported injuries and the characteristics of the victims. The data did not show an increase in the number of cases in 2020 compared to previous years, but we did find a notable increase in the severity of injuries.

Functional Decline in Emergency Department Patients with Dyspnea; a Register-Based Cohort

2021 ◽  
Author(s):  
Karoline Stentoft Rybjerg Larsen ◽  
Marianne Lisby ◽  
Hans Kirkegaard ◽  
Annemette Krintel Petersen
Keyword(s):  
Emergency Department ◽  
Electronic Patient Record ◽  
Hospital Admissions ◽  
Functional Decline ◽  
Patient Characteristics ◽  
Risk Of Death ◽  
Record Data ◽  
Emergency Department Patients ◽  
One Year ◽  
Historic Cohort

Abstract Background Functional decline is associated with frequent hospital admissions and elevated risk of death. Presumably patients acutely admitted to hospital with dyspnea have a high risk of functional decline. The aim of this study was to describe patient characteristics, hospital trajectory, and use of physiotherapy services of dyspneic patients in an emergency department. Furthermore, to compare readmission and death among patients with and without a functional decline, and to identify predictors of functional decline. Methods Historic cohort study of patients admitted to a Danish Emergency Department using prospectively collected electronic patient record data from a Business Intelligence Registry of the Central Denmark Region. The study included adult patients that due to dyspnea in 2015 were treated at the emergency department (ED). The main outcome measures were readmission, death, and functional decline. Results In total 2,048 dyspneic emergency treatments were registered. Within 30 days after discharge 20% was readmitted and 3.9% had died. Patients with functional decline had a higher rate of 30-day readmission (31.2% vs. 19.1%, p<0.001) and mortality (9.3% vs. 3.6%, p=0.009) as well as mortality within one year (36.1% vs. 13.4%, p<0.001). Predictors of functional decline were age ≥60 years and hospital stay ≥6 days. Conclusion Patients suffering from acute dyspnea are seen at the ED at all hours. In total one in five patients were readmitted and 3.9% died within 30 days. Patients with a functional decline at discharge seems to be particularly vulnerable.

81 Integrating A Front Door Frailty Service in the Emergency Department: Results of A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Dunnell ◽  
A Shrestha ◽  
E Li ◽  
Z Khan ◽  
N Hashemi
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Community Services ◽  
Service Improvement ◽  
Specialist Nurse ◽  
Front Door ◽  
Medication Changes ◽  
Health Service Improvement

Abstract Introduction Increasing old age and frailty is putting pressure on health services with 5–10% of patients attending the emergency department (ED) and 30% of patients in acute medical units classified as older and frail. National Health Service improvement mandates that by 2020 hospital trusts with type one EDs provide at least 70 hours of acute frailty service each week. Methodology A two-week pilot (Monday–Friday 8 am-5 pm) was undertaken, with a “Front Door Frailty Team” comprising a consultant, junior doctor, specialist nurse and pharmacist, with therapy input from the existing ED team. They were based in the ED seeing patients on arrival, referrals from the ED team and patients in the ED observation ward—opposed to the usual pathway of referral from the ED team to medical team. Data was captured using “Cerner” electronic healthcare records. A plan, do, study, act methodology was used throughout with daily debrief and huddle sessions. Results 95 patients were seen over two weeks. In the over 65 s, average time to be seen was 50 minutes quicker than the ED team over the same period, with reduced admission rate (25.7% vs 46.5%). The wait between decision to admit and departure was shortened by 119 minutes. Overall, this led to patients spending on average 133 minutes less in the ED. 64 patients were discharged, of which 44 had community follow-up (including 37.5% of 64 referred to acute elderly clinic and 25% to rapid response). 47 medications were stopped across 25 patients. Conclusion The pilot shows that introduction of an early comprehensive geriatric assessment in the ED can lead to patients being seen sooner, with more timely decisions over their care and reduction in hospital admissions. It allowed for greater provision of acute clinics and community services as well as prompt medication review and real time medication changes.

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