Title : Trends in and socio-economic factors affecting dental related admission paediatric population in the United States: A perspective from kid national database
Background: Untreated dental disease can significantly impact systemic health and may result in costly hospitalizations. The burden of dental-related hospital admissions in the paediatric population in the United States has not been reported previously, mainly focused on socioeconomic factors affecting it. Objectives of this study are (i) Describe the trend of dental-related admissions from 2000 to 2019 in paediatric populations and (ii) Study socio-economic factors predicting dental-related admissions in this cohort.
Methods: We accessed the national multicentre Kids’ Inpatient Database (KID) Healthcare Cost and Utilization Project (HCUP) from the years 2000 to 2019. We excluded encounters with neonatal/newborn admissions. Dental-related admissions were identified with primary/admitting diagnoses of ICD-9 (520.0?529.9, 792.4, 784.92, 802.2?802.5, 873.6?873.79, V52.3, V53.4, V58.5, V72.2, V45.84) and ICD-10 codes (K00-K09), respectively, for the years 2000-2012 and 2016-2019. A logistic regression model was performed to identify socioeconomic factors affecting dental-related hospitalizations. Weight-based analysis was performed using SAS 9.4 for complex sample design.
Results: A total of 21,497,670 paediatric admissions were analysed in this cohort. The prevalence of dental-related admission was 2.7 cases per 1000 paediatric admissions. The average admission rate was stable overall in years, but an increasing trend was found in the age group of 5-10 years. When looking at the top 10 reasons for dental-related admissions, the peri apical abscess was the most common reason, followed by maxillary hypoplasia. A statistically significant upward trend was found in the admission rate due to periapical abscesses and maxillary hypoplasia. In contrast, a downward trend was noted in jaw-cranial base diseases and maxillary hypoplasia anomalies. In a regression analysis, factors predicting dental-related admissions were age >10 years, male gender, white race, Private Insurance, higher median household income (>50th percentile), urban location, and living in northeast states
Conclusion: To our knowledge, this is the largest cohort based on a national multicentre database analysing paediatric dental-related hospitalization. An increasing trend in periapical abscess admission is a concern as it is a preventable cause and can increase healthcare costs if not addressed. Targeted educational and preventive strategies should be carried out toward identified high-risk socio-economic factors.
Audience Takes Away Notes:
- To our knowledge, this is the largest cohort based on a national multicentre database analyzing paediatric dental-related hospitalization.
- An increasing trend in periapical abscess admission is a concern as it is a preventable cause and can increase healthcare costs if not addressed.
- Targeted educational and preventive strategies should be carried out toward identified high-risk socio-economic factors (age >10 years, male gender, white race, higher median household income (>50th percentile), urban location, private insurance and living in northeast states) to prevent dental-related hospitalizations in the paediatric population.