Dataset Information

Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014.

ABSTRACT: OBJECTIVE:In Canada, non-traumatic dental conditions (NTDCs) presenting in emergency departments (EDs) are dealt with by non-dental professionals who are generally not equipped to deal with such emergencies, resulting in an inefficient usage of heath care resources. This study aimed to assess the burden of ED visits for NTDCs in Ontario by observing trends from 2006 to 2014. METHODS:Aggregate data for Ontario were obtained from the Canadian Institute for Health Information's National Ambulatory Care Reporting System. Data were examined for the whole of Ontario and stratified by 14 Local Health Integration Networks. Descriptive analysis was conducted for both number of people and number of visits, stratified by sex and age groups (0-5, 6-18, 19-64, and 65+ years). Numbers were also examined by neighbourhood stratifications, including urban/rural, income quintile and immigrant tercile. RESULTS:Over the study period, an upward trend of visiting EDs for NTDCs was observed. Approximately 403 628 people in Ontario made 482 565 visits over the period of nine years. On average, 341 per 100 000 people, per year, visited. Young children, people living in neighbourhoods with lower income and higher immigrant concentration, and people living in the rural regions, visited EDs more for NTDCs during 2006-2014. CONCLUSION:The upward and inequitable trends of utilization of EDs for NTDCs reinforce recognition of the important need for both universal and targeted approaches for primary prevention of dental conditions. To enhance equitable access to dental care, policy advocacy is required for publicly funding essential and emergency dental services for all.

SUBMITTER: Singhal S

PROVIDER: S-EPMC6972413 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014.

Singhal Sonica S McLaren Lindsay L Quinonez Carlos C

Canadian journal of public health = Revue canadienne de sante publique 20170501 3

<h4>Objective</h4>In Canada, non-traumatic dental conditions (NTDCs) presenting in emergency departments (EDs) are dealt with by non-dental professionals who are generally not equipped to deal with such emergencies, resulting in an inefficient usage of heath care resources. This study aimed to assess the burden of ED visits for NTDCs in Ontario by observing trends from 2006 to 2014.<h4>Methods</h4>Aggregate data for Ontario were obtained from the Canadian Institute for Health Information's Natio ...[more]

PMID: 31583607

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Project description:BackgroundThe US older adult population (age ≥65 years) is increasing and may be at increased risk for severe anaphylaxis. Little is known about the health care use for acute allergic reactions (AAR), including anaphylaxis, among older adults.ObjectiveTo characterize trends in emergency department (ED) visits and hospitalizations for AAR and anaphylaxis among US older adults from 2006 to 2014 and examine factors associated with severe anaphylaxis.MethodsWe performed cross-sectional analyses of trends in ED visits and hospitalizations among older adults using data from the Nationwide Emergency Department Sample and the National (Nationwide) Inpatient Sample in 2006 to 2014. We used International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes to identify visits for AAR, including anaphylaxis. Multivariable logistic regression modeling was used to identify factors associated with severe anaphylaxis (cardiac arrest, intubation, and death).ResultsIn 2006 to 2014, older adults experienced approximately 1,019,967 AAR-related ED visits, 173,844 AAR-related hospitalizations, 93,795 anaphylaxis-related ED visits, and 72,677 anaphylaxis-related hospitalizations. Whereas AAR-related ED visit and hospitalization rates remained stable (P = .28 and .16, respectively), anaphylaxis-related ED visit and hospitalization rates increased significantly over time (37 visits/100,000 in 2006 to 51 in 2014, P < .001; and from 13 hospitalizations/100,000 in 2006 to 23 in 2014, P < .001), especially hospitalization rates for drug-related anaphylaxis (47 hospitalizations/100,000 in 2006 to 85 in 2014; P < .001). Risk factors for anaphylaxis-related death included older age and drug-related trigger.ConclusionsIn a nationally representative sample of US older adults, the rate of anaphylaxis-related ED visits and hospitalizations increased over time. Drug-related triggers represented a substantial portion of increased health care use and are a growing risk in this vulnerable population.

Project description:Importance:The Patient Protection and Affordable Care Act of 2010 brought attention to adverse drug events in national patient safety efforts. Updated, detailed, nationally representative data describing adverse drug events can help focus these efforts. Objective:To describe the characteristics of emergency department (ED) visits for adverse drug events in the United States in 2013-2014 and describe changes in ED visits for adverse drug events since 2005-2006. Design, Setting, and Participants:Active, nationally representative, public health surveillance in 58 EDs located in the United States and participating in the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project. Exposures:Drugs implicated in ED visits. Main Outcomes and Measures:National weighted estimates of ED visits and subsequent hospitalizations for adverse drug events. Results:Based on data from 42?585 cases, an estimated 4.0 (95% CI, 3.1-5.0) ED visits for adverse drug events occurred per 1000 individuals annually in 2013 and 2014 and 27.3% (95% CI, 22.2%-32.4%) of ED visits for adverse drug events resulted in hospitalization. An estimated 34.5% (95% CI, 30.3%-38.8%) of ED visits for adverse drug events occurred among adults aged 65 years or older in 2013-2014 compared with an estimated 25.6% (95% CI, 21.1%-30.0%) in 2005-2006; older adults experienced the highest hospitalization rates (43.6%; 95% CI, 36.6%-50.5%). Anticoagulants, antibiotics, and diabetes agents were implicated in an estimated 46.9% (95% CI, 44.2%-49.7%) of ED visits for adverse drug events, which included clinically significant adverse events, such as hemorrhage (anticoagulants), moderate to severe allergic reactions (antibiotics), and hypoglycemia with moderate to severe neurological effects (diabetes agents). Since 2005-2006, the proportions of ED visits for adverse drug events from anticoagulants and diabetes agents have increased, whereas the proportion from antibiotics has decreased. Among children aged 5 years or younger, antibiotics were the most common drug class implicated (56.4%; 95% CI, 51.8%-61.0%). Among children and adolescents aged 6 to 19 years, antibiotics also were the most common drug class implicated (31.8%; 95% CI, 28.7%-34.9%) in ED visits for adverse drug events, followed by antipsychotics (4.5%; 95% CI, 3.3%-5.6%). Among older adults (aged ?65 years), 3 drug classes (anticoagulants, diabetes agents, and opioid analgesics) were implicated in an estimated 59.9% (95% CI, 56.8%-62.9%) of ED visits for adverse drug events; 4 anticoagulants (warfarin, rivaroxaban, dabigatran, and enoxaparin) and 5 diabetes agents (insulin and 4 oral agents) were among the 15 most common drugs implicated. Medications to always avoid in older adults according to Beers criteria were implicated in 1.8% (95% CI, 1.5%-2.1%) of ED visits for adverse drug events. Conclusions and Relevance:The prevalence of emergency department visits for adverse drug events in the United States was estimated to be 4 per 1000 individuals in 2013 and 2014. The most common drug classes implicated were anticoagulants, antibiotics, diabetes agents, and opioid analgesics.

Dataset Information

Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014.

Publications

Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014.

Similar Datasets

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