Socio-Economic Factors Predicting Dental-Related Admissions in a Pediatric Population in the United States: Findings From the National Kids' Inpatient Database

Objective: To describe the trend of dental-related admissions from 2000 to 2019 in pediatric populations and to investigate socio-economic factors predicting dental-related admissions in this cohort. Methods: The national multicentre Kids’ Inpatient Database (KID) Healthcare Cost and Utilization Project (HCUP) data were utilized from 2000 to 2019 for this study. Dental-related admissions were identified by scanning diagnosis fields DX1 through DX2 for International Classification of Diseases (ICD)-9-CM years and I10_DX1 through I10_DX40 for ICD-10-CM years. A binary outcome variable was created to flag any hospitalization with a dental-related diagnosis in any listed diagnosis position. While this approach maximizes capture of dental-related admissions, we acknowledge that inclusion of secondary diagnosis fields may introduce some degree of misclassification, as dental diagnoses in non-primary positions may not always represent the principal reason for hospitalization. This is noted as a study limitation. Statistical Analysis System (SAS) 9.4 was used for all the statistical analyses for this complex sample design. Results: Among a total of 21,497,670 pediatric hospital admissions from 2000 to 2019, dental-related admissions were 2.7 cases per 1,000 pediatric admissions. The average admission rates were stable over the years, but an increasing trend (3.3% to 5.8%) was seen for the children aged 5-10 years. Among the top 10 causes of dental-related hospital admissions, periapical abscess was the most common, followed by maxillary hypoplasia. A statistically significant upward trend was found in the admission rate due to periapical abscesses and maxillary hypoplasia. In contrast, a declining trend was noted in jaw-cranial base diseases and maxillary hyperplasia anomalies. Conclusion: Pediatric dental-related hospital admissions increased over time, driven by preventable conditions such as periapical abscesses. Differences in hospitalization risk by socio-demographic variables suggest that barriers to access timely preventive and specialty dental care may contribute to avoidable inpatient admissions.