Faculty Collaboration Database

Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States. J Am Dent Assoc 2013 Jul;144(7):828-36

Date

07/03/2013

Pubmed ID

23813265

Pubmed Central ID

PMC3817612

DOI

10.14219/jada.archive.2013.0195

Scopus ID

2-s2.0-84881091251 (requires institutional sign-in at Scopus site)   22 Citations

Abstract

BACKGROUND: Researchers have documented an association between waiting times in emergency departments (EDs) and quality of care for medical conditions, but little is known about trends and factors associated with waiting times for ED visits related to nontraumatic dental conditions (NTDCs). The authors examined trends in waiting time and associated factors for NTDC-related ED visits in the United States.

METHODS: The authors analyzed data from the National Hospital Ambulatory Medical Care survey for 1997 to 2007, excluding 2001 and 2002 owing to lack of information about waiting times. The authors used a survey-weighted linear regression of log-transformed waiting-time model to determine the waiting time for NTDC-related visits.

RESULTS: The geometric mean (standard error) waiting times for NTDC- and non-NTDC-related visits were 29 (1.0) and 25 (0.6) minutes, respectively (P < .01). The geometric mean waiting time for NTDC-related visits increased by 6 percent annually and from 20 minutes in 1997 to 37 minutes in 2007. Compared with whites, Hispanics and African Americans had significantly longer waiting times for NTDC-related visits (adjusted fold-difference [R] = 1.2, 95 percent confidence interval [CI] = 1.13-1.31) and [R] = 1.3, [CI] = 1.29-1.38). Age, payer type, reason for visit and triage category were significant predictors of waiting time (R = 2.3 and 2.4 for NTDC-related visits in the triage categories of more than one to two hours and more than two to 24 hours, respectively).

CONCLUSION: Nationally, waiting times in EDs for NTDC-related visits increased over time. Compared with whites, Hispanics and blacks waited longer to receive care for NTDCs in EDs.

PRACTICAL IMPLICATIONS: Prolonged waiting times associated with NTDC-related ED visits reinforce the need for dental professionals to continue to advise patients regarding the need to implement oral health preventive strategies and to avoid the use of the ED for preventable common dental conditions.

Author List

Okunseri C, Okunseri E, Chilmaza CA, Harunani S, Xiang Q, Szabo A

Authors

Christopher Okunseri DDS,MS Associate Professor and Director in the Clinical Services department at Marquette University
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Child
Child, Preschool
Dental Care
Emergency Service, Hospital
Female
Financing, Personal
Humans
Insurance, Health
Male
Medicaid
Medicare
Middle Aged
Minority Groups
Retrospective Studies
Sex Factors
Time Factors
Time-to-Treatment
Triage
United States
Waiting Lists
Young Adult