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.
Key Words: Dental care, emergency service, hospital, health status disparities
Résumé
OBJECTIF: Au Canada, les visites aux services d’urgence pour faire traiter des problèmes dentaires non traumatiques (PDNT) ne sont pas prises en charge par des professionnels dentaires; le personnel n’est généralement pas équipé pour composer avec ce type d’urgences, ce qui entraîne une mauvaise utilisation des ressources de soins de santé. Notre étude visait à évaluer le fardeau des visites aux urgences pour faire traiter des PDNT en Ontario en observant les tendances de 2006 à 2014.
MÉTHODE: Nos données agrégées pour l’Ontario proviennent du Système national d’information sur les soins ambulatoires de l’Institut canadien d’information sur la santé. Nous les avons examinées pour l’ensemble de l’Ontario et stratifiées selon 14 réseaux locaux d’intégration des services de santé. Nous avons effectué l’analyse descriptive du nombre de personnes et du nombre de visites, stratifiés par sexe et par groupe d’âge (0–5 ans, 6–18 ans, 19–64 ans et 65 ans et plus). Nous avons aussi examiné les chiffres stratifiés par quartier: quartiers urbains ou ruraux, quintile de revenu des quartiers et tercile d’immigrants des quartiers.
RÉSULTATS: Au cours de la période de l’étude, nous avons observé un mouvement de hausse dans les visites aux urgences pour faire traiter des PDNT. Environ 403 628 personnes en Ontario ont fait 482 565 visites aux urgences sur une période de neuf ans. Il y a eu en moyenne 341 visites pour 100 000 habitants par année. Les jeunes enfants, les résidents des quartiers à faible revenu et à forte concentration d’immigrants et les résidents des zones rurales ont davantage visité les urgences pour faire traiter des PDNT entre 2006 et 2014.
CONCLUSION: La hausse et le caractère inégal des tendances à recourir aux services d’urgence pour faire traiter des PDNT soulignent l’importance d’universaliser et de cibler les stratégies de prévention primaire des problèmes dentaires. Pour rendre l’accès aux soins dentaires plus équitable, il est nécessaire de promulguer des politiques de financement public universel des soins dentaires essentiels et urgents.
Mots Clés: soins dentaires, service hospitalier d’urgences, disparités de l’état de santé
Footnotes
Acknowledgement of Support: Canadian Institute for Health Information for providing data. LM is supported by an Applied Public Health Chair funded by CIHR (Institute of Population & Public Health and Institute of Musculoskeletal Health & Arthritis), the Public Health Agency of Canada, and Alberta Innovates - Health Solutions.
Conflict of Interest: None to declare.
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