{"pk":47316,"title":"Association Between Socioeconomic Status and Emergency Department Use for Non-traumatic Dental Conditions","subtitle":null,"abstract":"<p><strong>Introduction:</strong> Among ED visits, presentation for a non-traumatic dental condition represents one of the most preventable, as 79% of these visits are considered avoidable. Our goal was to investigate the association between individual-level socioeconomic status (SES) and emergency department (ED) use for non-traumatic dental conditions.</p>\n<p><strong>Methods: </strong>In this retrospective, pooled cross-sectional analysis we used data from a database of administrative health claims for members of large commercial and Medicare Advantage health plans. The sample included adults (≥ 18) who presented to the ED between 2017-2021 and had complete data on SES indicators (ie, income, education level, net worth, homeownership, and low-income subsidy status). The primary outcome was ED use for non-traumatic dental conditions, identified via International Classification of Diseases diagnosis codes. We used multivariate logistic regression models with marginal effects to examine the relationship between SES and ED visits, adjusted for demographics, geographic region, and disease burden.</p>\n<p><strong>Results:</strong> Among 3,894,785 individuals, 74,685 (1.9%) had an ED visit related to non-traumatic dental conditions. Lower SES was significantly associated with increased ED visits for these conditions, with income exhibiting the strongest effect. Compared to individuals earning &gt; $100,000 annually, those earning &lt; $40,000 were 0.7 percentage points (1.5% vs 2.2%) more likely to visit the ED for non-traumatic dental conditions (P &lt; .001). A dose-dependent effect was observed for the composite SES score, with individuals in the lowest SES quartile 1.3 percentage points (1.3% vs 2.6%) more likely to visit the ED compared to the highest quartile (P &lt; .001).</p>\n<p><strong>Conclusion:</strong> Lower socioeconomic status is associated with higher ED use for non-traumatic dental conditions, underscoring disparities in oral healthcare access. Targeted policy interventions and better integration of oral and medical healthcare systems are needed to reduce preventable ED visits.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Non-traumatic dental conditions"},{"word":"Socioeconomic Status"},{"word":"Claims data"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5ms5f7bw","frozenauthors":[{"first_name":"Heather","middle_name":"L.","last_name":"Taylor","name_suffix":"","institution":"Indiana University Richard M. Fairbanks of Public Health, Department of Health Policy and Management, Indianapolis, Indiana","department":""},{"first_name":"Paul","middle_name":"","last_name":"Musey","name_suffix":"","institution":"Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana","department":""},{"first_name":"Adam","middle_name":"","last_name":"Hirsch","name_suffix":"","institution":"Indiana University School of Science, Department of Psychology, Indianapolis, Indiana","department":""},{"first_name":"Thankam","middle_name":"","last_name":"Thyvalikakath","name_suffix":"","institution":"Regenstrief Institute, Center for Biomedical Informatics, Indianapolis, Indiana; Indiana University School of Dentistry, Department of Dental Public Health & Dental Informatics, Indianapolis, Indiana","department":""},{"first_name":"Joshua","middle_name":"R.","last_name":"Vest","name_suffix":"","institution":"Indiana University Richard M. Fairbanks of Public Health, Department of Health Policy and Management, Indianapolis, Indiana; Regenstrief Institute, Center for Biomedical Informatics, Indianapolis, Indiana","department":""}],"date_submitted":"2025-04-29T15:12:40.455000Z","date_accepted":"2025-10-27T19:50:12.208000Z","date_published":"2026-01-21T17:50:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47316/galley/49074/download/"}]}