title: The effect of North Carolina hospital payor mix on dental-related pediatric emergency room utilization.
abstract: OBJECTIVE
  We examined the effect of hospital payor mix on the proportion of pediatric emergency department (ED) visits that were dental related.
  
  
  METHODS
  We used the North Carolina (NC) Emergency Room Discharge Database from 2007 to 2009 to estimate the relationship between the percent of pediatric ED patients that were covered by Medicaid and the percent of pediatric ED visits that were dental related. Hospital-level fixed effects controlled for unobserved hospital-level characteristics. Discharge claims from 110 ED facilities in NC were analyzed over the 3-year study period. Claims were limited to individuals under 18 years old with dental disease-related International Classification of Diseases, Ninth Edition, Clinical Modification diagnostic codes, 520.00-530.00.
  
  
  RESULTS
  Using 327 hospital-years of data, 62 percent of ED visits for pediatric dental reasons were covered by Medicaid, a proportion over two times greater than for pediatric reasons overall, 26 percent. Hospitals with a greater proportion of Medicaid payors had a greater proportion of pediatric dental ED visits (P < 0.01).
  
  
  CONCLUSIONS
  Hospitals serving a large population of children on Medicaid should be prepared to provide emergency dental services. Public health administrators should prioritize oral health resources at hospital communities with a high proportion of Medicaid payors.
authors.affiliation: Departments of Pediatric Dentistry and Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Hom
authors.forename: Lane F
authors.initials: LF
authors.lastname: Burgette
authors.forename: Jessica Y
authors.initials: JY
authors.lastname: Lee
mesh_terms: D003752:Dental Health Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019458:Insurance Coverage; D008484:Medicaid; D009657:North Carolina; D010372:Pediatrics; D014481:United States
keywords: Medicaid; dental care for children; hospital emergency service
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