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Enhancing Dental Care Access in North Carolina Emergency Departments

This report highlights the pressing dental health issues in North Carolina's emergency departments (EDs), revealing that over 62,000 emergency dental visits by Medicaid enrollees could have been prevented with timely dental care. In 2009, more than 69,000 ER visits were linked to dental disorders, indicating a significant healthcare challenge. The majority of these patients were uninsured or on Medicaid, with rural populations disproportionately affected. Solutions to improve access include partnerships between healthcare facilities and community organizations, aiming for enhanced preventive care.

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Enhancing Dental Care Access in North Carolina Emergency Departments

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  1. Dental Services in the Emergency Department December 12, 2012 Improving the Health and Well-Being of North Carolinians

  2. Scope of the Problem

  3. Pew Report: • 1997: 62,000 emergency dental visits by Medicaid enrollees in North Carolina that could have been avoided if these patients had received preventive care from a dentist. • 2009: >69,000 ER visits to North Carolina hospitals due primarily to disorders of the teeth or jaw. The 10th most common reason for emergency trips in the state. • http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/Reports/State_policy/Pew_Report_A_Costly_Dental_Destination.pdf

  4. National Findings • 936,000 ED visits; 13,000 admissions for dental in 2009 • 16% increase from 2006 • 25-29 yo largest age demographic • Payer Mix: • 40% uninsured (vs 17% of all ED visits) • 30% Medicaid (vs. 25%) • 19% private insurance (vs. 33%) • Rural populations visited at rates twice that of urban (480 per 100,000 vs 217 per 100,000) • Accessibility of dental workforce a driving factor • Ernest Moy, U.S. Agency for Healthcare Research and Quality (AHRQ). From databases for EDs in 29 states.

  5. Local Findings • 1,013 visits with a dental complaint (1.3% of all visits) July 2010- June 2011. 4 resulted in admission • Mean patient age of 32 • 61% self-pay (vs. 22% all ED visits); 11% private (medical) • 97% treated and released; 10% dental procedure performed • 81% opiate at discharge; 69% antibiotic at discharge • No evidence based on days of week/time of day that patients presented when dental offices were closed • Michael Hocker et al: NCMJ: Dental Visits to a North Carolina Emergency Departmenthttp://www.ncmedicaljournal.com/wp-content/uploads/2012/09/NCMJ_73502_FINAL.pdf

  6. BCBSNC Commercial Population

  7. Claims & Dental Workforce Distribution

  8. Local Solutions

  9. Partnerships to improve access • Blue Ridge Community Health Center & Pardee Hospital, Hendersonville, NC • Traci Spence Director of Operations, BRCHS 828.692.4289 Ext. 2460 tspence@brchs.com

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