Emergency department visits for infectious oral conditions in Massachusetts, 2014 through 2018

Abstract

Background: The authors aimed to measure population-based preventable emergency department (ED) visits related to infectious oral conditions (IOCs) in Massachusetts and to examine the associated sociodemographic factors to support prevention efforts. Methods: A statewide retrospective analysis of ED visits related to IOCs in Massachusetts from 2014 through 2018 was conducted using a Center for Health Information and Analysis database. The authors described patients' characteristics, dental diagnoses frequencies, emergency severity, lengths of stay, associated treatment, and costs. Multilevel logistic regression was used to assess factors associated with IOC visits. Results: IOC visits in 2014 through 2018 were 1.2% (149,777) of the total ED visits, with an estimated cost of $159.7 million. There was an annual decline in the prevalence of IOC visits from 2014 through 2018. After adjusting for sociodemographic factors, odds of IOC were higher among males (adjusted odd ratio [AOR], 1.26; 95% CI, 1.24 to 1.27), non-Hispanic Blacks compared with non-Hispanic Whites (AOR, 1.03; 95% CI, 1.02 to 1.06), people residing in dental health care professional shortage areas (AOR, 1.06; 95% CI, 1.04 to 1.07), public insurance beneficiaries (AOR, 1.90; 95% CI, 1.87 to 1.93), or uninsured (AOR, 2.60; 95% CI, 2.54 to 2.66) compared with privately insured. Conclusions: There was an annual decline in the prevalence of IOC visits from 2014 through 2018. Higher odds of IOC visits were associated with young adults, Black patients, uninsured people, public insurance beneficiaries, and people who reside in dental health care professional shortage areas. Practical Implications: The authors provided statewide data to support proposed policies to improve oral health care in Massachusetts. IOCs are mostly preventable, but well-coordinated care between medicine and dentistry is integral for prevention.