Abstract
In Canada, about 1% of all emergency room (ER) visits in a given year are made by patients with a primary diagnosis of a non-traumatic, non-urgent and yet preventable condition, such as tooth decay. This percentage is typically dismissed as irrelevant. Using 2013–2014 British Columbia data on ER use from the Canadian Institute for Health Information, however, we argue that the 1% figure (and its associated cost) has to be considered beyond its percentage value. In 2013–2014 alone, 12 357 non-traumatic dental visits were made to ERs in BC representing 1% of the total number of ER visits at a cost of $154.8 million to the taxpayers (across Canada, all visits to ER cost $1.8 billion/year). But the vast majority of these dental visits are discharged while the oral problem likely persists, hence taxpayer dollars are wasted. The belief thatthese dental-related ER visits are insignificantwithin the total costfor the health care system is misleading: treatment is not given, the problem is not resolved, and yet there is a high costto taxpayers and to the society at large. Public health resources should be reallocated.
Key Words: Emergency room, dental emergencies, cost, public health, policy
Résumé
Au Canada, environ 1 % des visites aux services d’urgence (SU) chaque année sont faites par des patients dont le diagnostic primaire concerne un problème évitable non traumatique et non urgent, comme la carie dentaire. Ce pourcentage est généralement tenu pour négligeable. D’après les données de 2013–2014 de l’Institut canadien d’information sur la santé sur l’utilisation des SU en Colombie-Britannique, nous faisons valoir que le chiffre de 1 % (et ses coûts associés) doit être considéré au-delà de sa valeur de pourcentage. En 2013–2014 seulement, il y a eu 12 357 visites aux SU pour faire traiter des problèmes dentaires non traumatiques en Colombie-Britannique, ce qui représente 1 % du nombre total de visites aux SU et a coûté 154,8 millions de dollars aux contribuables (à l’échelle du Canada, les visites aux SU coûtent 1,8 milliard de dollars par année). Mais la très grande majorité des personnes qui se présentent aux urgences pour des problèmes dentaires reçoivent leur congé malgré la persistance probable de leurs problèmes, ce qui constitue un gaspillage de fonds publics. Il est illusoire de croire que les visites aux SU pour faire traiter des problèmes dentaires ne représentent qu’une part négligeable des coûts totaux du système de soins de santé: aucun traitement n’est donné, les problèmes ne sont pas résolus, et pourtant cela coûte cher aux contribuables et à la société. Il y aurait lieu de réaffecter des ressources de santé publique.
Mots Clés: services d’urgence, urgence dentaire, coût, santé, publique, politique (principe)
Footnotes
Acknowledgements: This manuscript originated as part of the secon’s (SHA) requirements for the completion of a Masters of Craniofacial Sciences, successfully concluded in August 2016 at The University of British Columbia’s Faculty of Dentistry. We thank Dr. Shimae Soheilipour for her input on data analysis. A special thank you to Mr. Glenn R. Knowles for his editorial work. This manuscript was based on the second author’s oral presentation during the 2016 conference of the Canadian Association of Public Health Dentistry in October in Edmonton, Canada.
Conflict of Interest: None to declare.
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