%0 Journal Article
%T Emergency Department Utilization for Oral Health Complications Among Adolescents with Developmental Disabilities
%A Niklas O. Lund
%A Lucia F. Romano
%A Nur S. Ismail
%J Journal of Current Research in Oral Surgery
%@ 3062-3480
%D 2024
%V 4
%N 1
%R 10.51847/eYOdHWvCGl
%P 161-172
%X We conducted a cross-sectional analysis using Andersen’s Behavioral Model to examine the predictors of emergency department (ED) visits among adolescents, with statistical adjustment for the presence of developmental disabilities (DD) and at least one oral health issue (such as toothaches, dental caries, gingival bleeding, or problems with eating/swallowing). This secondary analysis utilized data from the 2016–2019 National Survey of Children’s Health (NSCH). Sample characteristics were summarized using descriptive statistics, including frequencies and percentages. Bivariate relationships were examined with chi-square tests, and multivariable logistic regression was employed to model predictors of emergency department visits among adolescents aged 10–17, adjusting for predisposing, enabling, and need-related factors. The study drew on a cohort of 68,942 adolescents, most of whom were U.S.-born, non-Hispanic White, and male. Based on parent responses, the majority (69%) did not have a developmental disability (DD) or any oral health concerns. A smaller portion—10%—experienced at least one oral problem without having a DD, while 16% were identified as having a DD alone. Only 5% were reported to have both a DD and oral complications. Among all groups, adolescents with both conditions showed the greatest reliance on emergency department (ED) care, with 33% having made an ED visit, compared with 14% in the group without either condition. Findings from the multivariable model indicated that having both a DD and an oral complication doubled the odds of an ED visit (OR = 2.0, 95% CI: 1.64–2.54, p < 0.0001). Adolescents with a DD alone also demonstrated elevated odds (OR = 1.45, 95% CI: 1.25–1.68, p < 0.0001). Lacking a Medical Home contributed to a modest but significant increase in ED use (14%, p = 0.02). In contrast, two factors—private insurance coverage (OR = 0.63, 95% CI: 0.53–0.75, p < 0.0001) and living in a household where someone had completed at least some college (OR = 0.85, 95% CI: 0.73–0.98, p = 0.03)—were associated with decreased likelihood of ED utilization. Adolescents who have both developmental disabilities and oral health problems visit the emergency department much more often than those with neither condition. Better integration of dental and medical care, along with stronger adoption of Patient-Centered Medical Home principles, could improve overall care quality and substantially decrease unnecessary ED visits for these adolescents.
%U https://tsdp.net/article/emergency-department-utilization-for-oral-health-complications-among-adolescents-with-developmental-krbnprej314dst9