scholarly journals Emergency and Urgent Dental Visits among Medicaid Enrollees from 2013 to 2017

2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric Tranby

Abstract Background: Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.Keywords: Emergency Dental, COVID-19, Teledental, Medicaid

2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric Tranby

Abstract Background: Efforts to combat the spread of COVID-19 have led to guidance to restrict dental practice to treating emergency and urgent dental visits and reduce or eliminate elective dental procedures. Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric P. Tranby

Abstract Background Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs. Methods Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.


2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric P Tranby

Abstract Background: Efforts to combat the spread of COVID-19 have led to guidance to restrict dental practice to treating emergency and urgent dental visits and reduce or eliminate elective dental procedures. Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states.Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, with the majority returning within 30 days for that treatment.Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.


2018 ◽  
Author(s):  
Eric Knowles ◽  
Linda Tropp

Donald Trump's ascent to the Presidency of the United States defied the expectations of many social scientists, pundits, and laypeople. To date, most efforts to understand Trump's rise have focused on personality and demographic characteristics of White Americans. In contrast, the present work leverages a nationally representative sample of Whites to examine how contextual factors may have shaped support for Trump during the 2016 presidential primaries. Results reveal that neighborhood-level exposure to racial and ethnic minorities is associated with greater group threat and racial identification among Whites, as well as greater intentions to vote for Trump in the general election. At the same time, however, neighborhood diversity afforded Whites with opportunities for intergroup contact, which is associated with lower levels of threat, White identification, and Trump support. Further analyses suggest that a healthy local economy mutes threat effects in diverse contexts, allowing contact processes to come to the fore.


2021 ◽  
pp. 089590482110199
Author(s):  
Jennifer A. Freeman ◽  
Michael A. Gottfried ◽  
Jay Stratte Plasman

Recent educational policies in the United States have fostered the growth of science, technology, engineering, and mathematics (STEM) career-focused courses to support high school students’ persistence into these fields in college and beyond. As one key example, federal legislation has embedded new types of “applied STEM” (AS) courses into the career and technical education curriculum (CTE), which can help students persist in STEM through high school and college. Yet, little is known about the link between AS-CTE coursetaking and college STEM persistence for students with learning disabilities (LDs). Using a nationally representative data set, we found no evidence that earning more units of AS-CTE in high school influenced college enrollment patterns or major selection in non-AS STEM fields for students with LDs. That said, students with LDs who earned more units of AS-CTE in high school were more likely to seriously consider and ultimately declare AS-related STEM majors in college.


2021 ◽  
pp. 000276422110031
Author(s):  
Laura Robinson ◽  
Jeremy Schulz ◽  
Øyvind N. Wiborg ◽  
Elisha Johnston

This article presents logistic models examining how pandemic anxiety and COVID-19 comprehension vary with digital confidence among adults in the United States during the first wave of the pandemic. As we demonstrate statistically with a nationally representative data set, the digitally confident have lower probability of experiencing physical manifestations of pandemic anxiety and higher probability of adequately comprehending critical information on COVID-19. The effects of digital confidence on both pandemic anxiety and COVID-19 comprehension persist, even after a broad range of potentially confounding factors are taken into account, including sociodemographic factors such as age, gender, race/ethnicity, metropolitan status, and partner status. They also remain discernable after the introduction of general anxiety, as well as income and education. These results offer evidence that the digitally disadvantaged experience greater vulnerability to the secondary effects of the pandemic in the form of increased somatized stress and decreased COVID-19 comprehension. Going forward, future research and policy must make an effort to address digital confidence and digital inequality writ large as crucial factors mediating individuals’ responses to the pandemic and future crises.


Author(s):  
Sarah M. Frank ◽  
Lindsay M. Jaacks ◽  
Carolina Batis ◽  
Lana Vanderlee ◽  
Lindsey Smith Taillie

Close economic ties encourage production and trade of meat between Canada, Mexico, and the US. Understanding the patterns of red and processed meat consumption in North America may inform policies designed to reduce meat consumption and bolster environmental and public health efforts across the continent. We used nationally-representative cross-sectional survey data to analyze consumption of unprocessed red meat; processed meat; and total red and processed meat. Generalized linear models were used to separately estimate probability of consumption and adjusted mean intake. Prevalence of total meat consumers was higher in the US (73.6, 95% CI: 72.3–74.8%) than in Canada (65.6, 63.9–67.2%) or Mexico (62.7, 58.1–67.2%). Men were more likely to consume unprocessed red, processed, and total meat, and had larger estimated intakes. In Mexico, high wealth individuals were more likely to consume all three categories of meat. In the US and Canada, those with high education were less likely to consume total and processed meat. Estimated mean intake of unprocessed red, processed, and total meat did not differ across sociodemographic strata. Overall consumption of red and processed meat remains high in North America. Policies to reduce meat consumption are appropriate for all three countries.


Author(s):  
Akash Patel ◽  
Jana L. Hirschtick ◽  
Steven Cook ◽  
Bukola Usidame ◽  
Ritesh Mistry ◽  
...  

The use of electronic nicotine delivery systems (ENDS) among youth in the United States has increased rapidly in the past decade. Simultaneously, while youth cigarette smoking has declined considerably, youth are still more likely to use menthol cigarettes than any other age group. We used nationally representative data on 15–17-year-olds from the Population Assessment of Tobacco and Health (PATH) Study and the National Youth Tobacco Survey (NYTS) (2013–2017) to better understand current cigarette (by menthol flavoring) and ENDS use in the US. We calculated weighted population prevalence estimates across years for multiple patterns of current cigarette and ENDS use (i.e., exclusive menthol cigarette, exclusive non-menthol cigarette, exclusive ENDS, dual ENDS and menthol cigarette, and dual ENDS and non-menthol cigarette) by sex, race/ethnicity, parental education level, household income, and homeownership. Overall, both exclusive menthol and non-menthol cigarette use declined from 2013–2017. Exclusive ENDS use increased, particularly among youth who were non-Hispanic White or had a higher socioeconomic status (measured by parental education, household income, and homeownership). Dual use of ENDS with either menthol or non-menthol cigarettes did not change significantly. Monitoring changes in these sociodemographic patterns will help inform future youth tobacco prevention strategies.


Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.


2021 ◽  
pp. 089011712110291
Author(s):  
Puneet Kaur Chehal ◽  
Livvy Shafer ◽  
Solveig Argeseanu Cunningham

Purpose: This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. Design: Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children’s Health. Setting: US, national. Subjects: Children ages 10-17 years (n = 34,640) Measures: Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. Analysis: Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. Results: An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. Conclusion: Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.


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