Travel distances by Wisconsin Medicaid enrollees who visit emergency departments for dental care. J Public Health Dent 2016 Jun;76(3):213-9
Date
01/23/2016Pubmed ID
26797756Pubmed Central ID
PMC4956604DOI
10.1111/jphd.12138Scopus ID
2-s2.0-84958068986 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
OBJECTIVES: Prior studies document increased numbers of nontraumatic dental condition (NTDC) visits to U.S. emergency departments (EDs). However, the influence of travel distance on ED use for NTDCs, particularly for Medicaid enrollees has hitherto received little attention. The authors examined the effect of travel distance on Wisconsin Medicaid enrollees' NTDC visits to EDs after adjustment for covariates.
METHODS: NTDC-related visits claims data for Wisconsin Medicaid (2001-2009) was analyzed. For each enrollee, travel distance to the nearest of 130 EDs in Wisconsin was determined. The number of NTDC visits per person-year was aggregated by ZIP+4 of residence. Negative binomial regression adjusting for the expected number of visits based on race, sex, age of the residents and calendar year was used to evaluate the effect of travel distance, urbanicity, and dentist-population ratio on rate of visits.
RESULTS: Enrollees residing in rural counties, entire dental health professional shortage areas, areas with dentist population ratios >20,000: 1 and non-Hispanic Whites travelled the furthest, compared to nearest mean ED distance of 2.9 miles. Enrollees residing 3 miles away or further had significantly lower rates of NTDC visits to EDs.
CONCLUSIONS: This study demonstrates that distance is a barrier to making NTDC-related visits to EDs. Rates of NTDC visits decreased as travel distance to the nearest ED increased for Medicaid enrollees.
Author List
Okunseri C, Vanevenhoven R, Chelius T, Beyer KM, Okunseri E, Lobb WK, Szabo AAuthors
Kirsten M. Beyer PhD, MPH Professor in the Institute for Health and Equity department at Medical College of WisconsinThomas H. Chelius Biostatistician I in the Institute for Health and Equity department at Medical College of Wisconsin
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
AdolescentAdult
Child
Child, Preschool
Dental Care
Emergency Service, Hospital
Female
Health Services Accessibility
Humans
Infant
Male
Medicaid
Middle Aged
Stomatognathic Diseases
Travel
United States
Wisconsin
