Analysis of Dental-related Emergency Department Utilization in Michigan

Objective: Emergency departments (ED) are critical to the United States healthcare system. However, they are known to be inefficient environments to deliver definitive care including management of dental emergencies. ED’s may also serve as an inadvertent, but important, stop gap for individuals who lack dental coverage. The nation’s healthcare system continues to struggle with inadequate resources to provide dental care for vulnerable patients who disproportionately suffer from dental-related conditions. Method: This study is an analysis on dental-related ED utilization in the state of Michigan. The authors collaborated with the Michigan Health & Hospital Association who provided data from the Michigan Inpatient and Outpatient Database for dental-related hospital emergency department (ED) visits in Michigan hospitals during 2018-2019. University of Michigan Medical School’s committee on human subjects’ research reviewed the protocol and provided IRB exemption (HUM00192629). Results: State funded Medicaid (33%) and federally funded Medicare (33%) were the most common payer types for patients with dental-related conditions who reported to Michigan ED’s from 2018 to 2019. Charges per ED encounter was the highest for Medicare, $2,900-$3,200, and lowest for other payers, $1,300-$1,500. Charges for ED-inpatient per encounter were the highest for Medicare ($22,000-$24,000). The age range for which patients most frequently presented to the emergency department (ED) was 25-64. However, expenses per encounter for patients 65 and older were roughly two to three times higher than for patients in other age ranges. Conclusion: The study revealed a disproportionately higher percentage of patients who identified as Black presented to Michigan emergency departments (30%) with a dental-related emergency.