Emergency department use for nontraumatic dental conditions for children with special health care needs enrolled in Oregon Medicaid.

Abstract

Background: This cross-sectional study evaluated whether children with special health care needs (CSHCN) were more likely to use the emergency department (ED) for nontraumatic dental conditions (NTDCs) than children without special health care needs (SHCN). The study also examined whether the likelihood of receiving an opioid prescription after an NTDC-ED visit differed between children with and without SHCN.

Methods: This analysis was based on 2017 Oregon Medicaid enrollment, claims, and pharmacy data (N = 225,614 children aged 3-17 years). To assess associations between SHCN, NTDC-ED use, and receipt of opioid prescriptions, confounding variable-adjusted odds ratios and 95% CIs were generated from logistic regression models.

Results: Approximately 14% (n = 31,867) of children had an SHCN. The prevalence of NTDC-ED use was 0.36% (n = 807) for all children. In the confounding variable-adjusted model, the odds of NTDC-ED use were 1.6 times greater for CSHCN than children without SHCN (95% CI, 1.3 to 1.9; P < .001). Among children with an NTDC-ED visit, 8.3% received an opioid prescription. In the confounding variable-adjusted model, CSHCN were at lower odds of receiving an opioid prescription after an NTDC-ED visit than children without SHCN, but this difference was not statistically significant (odds ratio, 0.84; 95% CI, 0.4 to 1.6; P = .57).

Conclusions: CSHCN enrolled in Medicaid had significantly higher odds of having NTDC-ED visits than children without SHCN, but there was no significant difference between the 2 groups in the odds of receiving an opioid prescription after an NTDC-ED visit.

Practical implications: All children, especially those with SHCN, should have adequate access to office-based oral health care through a dental home to reduce use of the ED for NTDC.