Racial and ethnic disparities in nontraumatic dental-condition visits to emergency departments and physician offices: a study of the Wisconsin Medicaid program.
BACKGROUND
Nontraumatic dental condition (NTDC) visits occur in emergency departments (EDs) and physician offices (POs), but little is known about factors associated with NTDC visit rates to EDs and POs.


METHODS
The authors analyzed all Medicaid dental claims in Wisconsin from 2001 through 2003 to examine factors associated with NTDC visits to EDs and POs. They performed bivariate and multivariable analyses. The independent variables they examined included race/ethnicity, age, sex, dental health professional shortage area (DHPSA) designation and urban influence code for county of residence.


RESULTS
The authors evaluated 956,774 NTDC visits made during 1,718,006 person-years; 4.3 percent of visits occurred in EDs or POs. Native Americans, African-Americans and enrollees of unknown race/ethnicity had the highest unadjusted ED and PO visit rates for NTDCs. African-Americans, Native Americans, adults and residents in partial or entire DHPSAs had significantly higher adjusted rates of NTDC visits to EDs. The authors observed significantly higher adjusted NTDC visit rates to POs for Native Americans, adults and enrollees residing in entire DHPSAs, and a significantly lower adjusted rate among African-Americans.


CONCLUSIONS
Native Americans, those residing in entire DHPSAs and adults have significantly higher risks of NTDC visits to EDs and POs. African-Americans are at increased risk of making visits to EDs for NTDCs but at decreased risk of making visits to POs for NTDCs.


CONCLUSIONS
Reductions in Medicaid visits to EDs and POs and the associated costs might be achieved by improving dental care access and targeted educational strategies among minorities, DHPSA residents and adults.
Okunseri
Christopher
C
Department of Clinical Services, Marqutte University School of Dentistry, Milwaukee 53201-1881, Wisconsin. USA. christopher.okunseri@marquette.edu
Pajewski
Nicholas M
NM
Brousseau
David C
DC
Tomany-Korman
Sandy
S
Snyder
Andrew
A
Flores
Glenn
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D003729:Dental Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010824:Physicians' Offices; D044469:Racial Groups; D017678:Sex Distribution; D014481:United States; D014922:Wisconsin; D055815:Young Adult