Nontraumatic Dental Emergency Department Visits and Follow Up Dental Care Among Wisconsin Medicaid Beneficiaries
Qishi Zhan, Tao Cui, Naveen Bansal, Maharaj Singh, Wenhui Sheng, Shengtong Han, Pradeep BhagavatulaABSTRACT
Objectives
Emergency department (ED) visits for nontraumatic dental conditions (NTDCs) are a persistent concern for Medicaid beneficiaries. This study examined factors associated with NTDC‐related ED utilization and dental follow up among Wisconsin Medicaid beneficiaries.
Methods
We conducted a retrospective claims‐based cohort study using Wisconsin Medicaid claims from January 1, 2014, through December 31, 2019. The ED cohort ( n = 553,669) outcome was at least one NTDC‐related ED visit. The follow up cohort ( n = 21,386 with an index NTDC‐related ED visit) outcome was at least one nonemergency dental visit within 6 months. Multivariable logistic regression estimated adjusted associations. Supplementary analyses used a logistic prediction model and LightGBM under a balanced modeling framework.
Results
Adults had the highest NTDC‐related ED visit rate (6.0%), exceeding children (1.5%) and older adults (1.5%). Rates were higher among White (4.4%) and Black (4.1%) beneficiaries than among Hispanic beneficiaries (2.7%). Only 8.8% of beneficiaries with an NTDC‐related ED visit received dental follow up within 6 months. After adjustment, HMO enrollment, adult age group, and residence in non‐Milwaukee urban or rural areas were associated with higher odds of NTDC‐related ED visits. For follow up, the highest area level income quartile had greater odds of subsequent nonemergency dental care.
Conclusions
NTDC‐related ED utilization and post ED dental follow up were associated with demographic, socioeconomic, geographic, and insurance related factors. The low follow up rate suggests a substantial gap between emergency care and subsequent nonemergency dental care, supporting care coordination, Medicaid dental access, and regional strategies for connecting ED patients to dental providers.