Barrier to Care: Emergency Department Utilization for Non-traumatic Dental Conditions in California

ABSTRACTIntroduction Every year in the United States, emergency departments (EDs) receive approximately 2.4 million non-traumatic dental condition (NTDC) visits. The American Association of State and Territorial Dental Directors (ASTDD) developed a surveillance guideline to understand which specific conditions dental infrastructure can address before patients succumb to the ED for care.Methods Descriptive epidemiology data of ED encounters from the California Department of Health Care Access and Information were analyzed. Primary diagnostic NTDCs in California EDs between 2016 and 2019 were reviewed using ASTDD surveillance protocol. Ophthalmic condition surveillance, with guidance from California Health and Human Services data, was used as a comparison due to similar national ED utilization rates.Results In California, 82 unique codes were used for primary NTDC diagnoses for the approximate 54,000 NTDC visits annually. The most common NTDC code was “Other Specified Disorders of Teeth and Supporting Structures,” accounting for 74–80% of all NTDC diagnoses. Ophthalmic condition codes had greater specificity with 12% as their most frequent code for “laceration without a foreign body of the left eyelid.”Conclusion Relatively few dental-related ED visits are associated with highly informative NTDC codes, limiting surveillance efforts to track the prevalence of underlying conditions. There is an opportunity to guide patients to proper dental care by 1) forming dental partners with EDs and 2) establishing referral protocol through case managers. If an ED had a standardized workflow to guide patients to dental care, a significant barrier could be addressed for both patients and providers

Measuring the constructs of health literacy in the Iranian adult Kurdish population

Background: Health literacy is essential to self-care, which is an important precedence to improve the quality of healthcare services and a key factor in health. It also plays a pivotal role in decision-making in various health fields. Therefore, policymakers consider health literacy to be a primary tool to promote community health and enhance the proper use of healthcare services. The present study aimed to assess the health literacy status of the Kurdish population in Kurdistan province, Iran based on the nine constructs of the Iranian health literacy questionnaire (IHLQ) individually and collectively and determine the significant effects of demographic variables on health literacy. Methods: This cross-sectional study was conducted on the Iranian adult Kurdish population living in the urban and rural areas of Kurdistan province, willing to participate during April 2017�September 2018. Data were collected using the IHLQ. The sample size was determined to be 980 people, with 490 in the rural areas and 490 in the urban areas. The researchers visited potential participants at their doorstep, asking them to complete the questionnaire. The willing participants were assisted in completing the IHLQ in case they were illiterate; the questions and answers were read by the researchers to the participants, and the responses were recorded. Results: About 50.4 (n = 494) of the Kurdish population had poor health literacy, while 34.0 (n = 333) had average health literacy, and 15.6 (n = 153) had good health literacy. Meanwhile, 60.2 of the participants obtained poor scores in the construct of health information access, and 74.1 (n = 726) obtained poor scores in the individual empowerment construct. In addition, the analysis of the adjusted model indicated that education level (lowest β = 7.42; P = 0.001) and in male participants (β = � 1.10; P = 0.001) were significantly associated with higher health literacy. Conclusion: According to the results, the investigated Kurdish population mostly had average or low health literacy. Therefore, proper strategies should be adopted to enhance the health literacy of this population and increase their access to health information. Furthermore, effective training should be provided to these individuals (especially vulnerable social groups) to improve their individual capabilities to compensate for poor health literacy. © 2021, The Author(s)