Understanding Emergency Room Visits for Nontraumatic Oral Health Conditions in a Hospital Serving Rural Appalachia: Dental Informatics Study

Raj K Khanna; Alfred A Cecchetti; Niharika Bhardwaj; Bobbi Steele Muto; Usha Murughiyan

doi:10.2196/31433

Understanding Emergency Room Visits for Nontraumatic Oral Health Conditions in a Hospital Serving Rural Appalachia: Dental Informatics Study

JMIR Form Res. 2022 Dec 23;6(12):e31433. doi: 10.2196/31433.

Authors

Raj K Khanna¹, Alfred A Cecchetti², Niharika Bhardwaj², Bobbi Steele Muto¹, Usha Murughiyan²

Affiliations

¹ Department of Dentistry, Oral & Maxillofacial Surgery, Joan C Edwards School of Medicine, Marshall University, Huntington, WV, United States.
² Department of Clinical and Translational Science, Joan C Edwards School of Medicine, Marshall University, Huntington, WV, United States.

PMID: 36563041
PMCID: PMC9823565
DOI: 10.2196/31433

Abstract

Background: In the Appalachian region, a variety of factors will impact the ability of patients to maintain good oral health, which is essential for overall health and well-being. Oral health issues have led to high costs within the Appalachian hospital system. Dental informatics examines preventable dental conditions to understand the problem and suggest cost containment.

Objective: We aimed to demonstrate the value of dental informatics in dental health care in rural Appalachia by presenting a research study that measured emergency room (ER) use for nontraumatic dental conditions (NTDCs) and the associated economic impact in a hospital system that primarily serves rural Appalachia.

Methods: The Appalachian Clinical and Translational Science Institute's oral health data mart with relevant data on patients (n=8372) with ER encounters for NTDC between 2010 and 2018 was created using Appalachian Clinical and Translational Science Institute's research data warehouse. Exploratory analysis was then performed by developing an interactive Tableau dashboard. Dental Informatics provided the platform whereby the overall burden of these encounters, along with disparities in burden by age groups, gender, and primary payer, was assessed.

Results: Dental informatics was essential in understanding the overall problem and provided an interactive and easily comprehensible visualization of the situation. We found that ER visits for NTDCs declined by 40% from 2010 to 2018, but a higher percentage of visits required inpatient care and surgical intervention.

Conclusions: Dental informatics can provide the necessary tools and support to health care systems and state health departments across Appalachia to address serious dental problems. In this case, informatics helped identify that although inappropriate ER use for NTDCs diminished due to ER diversion efforts, they remain a significant burden. Through its visualization and data extraction techniques, dental informatics can help produce policy changes by promoting models that improve access to preventive care.

Keywords: cost; dental informatics; economic impact; emergency room; nontraumatic dental care; utilization; visualization.

©Raj K Khanna, Alfred A Cecchetti, Niharika Bhardwaj, Bobbi Steele Muto, Usha Murughiyan. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.12.2022.