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Hospital-based ED visits with dental conditions among geriatric patients

Romesh P Nalliah, Min Kyeong Lee, Sankeerth Rampa, Michael Whitcomb, Veeratrishul Allareddy, Veerasathpurush Allareddy
Journal of the Massachusetts Dental Society 2013, 62 (2): 24-8

OBJECTIVE: To provide nationally representative estimates of all hospital-based emergency department (ED) visits with dental caries, pulp and periapical lesions, gingival/periodontal lesions, and mouth cellulitis occurring among the older population groups (aged 60 years and above).

METHODS: The 2008 Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project was used. This database provides weighted estimates of all ED visits in the United States (approximately 150 million). Hospital discharges with primary procedure ICD-9-CM codes for dental conditions in adults aged 60 and older were evaluated. All estimates obtained from the sample were projected to national levels.

RESULTS: A total of 50,881 ED visits had a dental condition including dental caries (33.6%), pulpal lesions (10.4%), periapical abscess (36%), gingival conditions (11%), and cellulitis (6.7%). Close to 72.7% were discharged routinely and 25.1% were admitted as inpatients into the same hospitals. About 63.4% of ED visits were covered by Medicare. Close to 40% of all ED visits occurred in the southern regions. The mean charge per ED visit was $1,114, and the total charges across the entire United States were $44.8 million.

CONCLUSIONS: In comparison to other age groups, older adults are hospitalized more frequently after ED visits for dental conditions. As the U.S. population ages, innovative programs are necessary to manage dental conditions in dental offices and reduce the number of ED visits and hospitalizations for dental complaints by older adults.


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