Dental Quality Alliance to test measures on use of ERs for caries-related reasons

Meeting of importance: Dr. W. Ken Rich, Dental Quality Alliance chair, listens at the Dec. 6 meeting, where a resolution to validate three measures related to the use of emergency rooms and caries-related treatment was passed. 

The Dental Quality Alliance will test a new set of measures that evaluate the use of emergency rooms for caries-related reasons.

At its Dec. 6 meeting at ADA Headquarters in Chicago, the DQA approved a resolution that funds a proposal from the University of Florida to validate three measures related to the advanced caries management and pediatric health status project. The measures include the use of ERs by patients with problems related to caries; a follow-up after a visit to the ER; and the use of general anesthesia for caries-related treatment.

The University of Florida will use Medicaid data from Florida and Texas to determine if the ER measures are appropriate.

“Inappropriate use of health care has become a major concern in this era of health care reform, especially the inappropriate use of emergency rooms. This care is not only inappropriate but also very expensive,” said Dr. W. Ken Rich, DQA chair. “It has long been known that people with dental pain will seek relief by presenting to an emergency room. The extent of this problem can only be determined if we have a way to evaluate it. These measures will not only quantify but will hopefully lead to a solution to this problem of inappropriate use of our health care system.”


“Testing and developing measures on the use of emergency rooms, especially follow-up after such use compliments the ADA’s Action for Dental Health, a major campaign aimed at ending the dental health crisis affecting tens of millions of Americans,” said Dr. David Schirmer, representing the ADA Council on Access, Prevention and Interprofessional Relations on the DQA. “One of the major pillars of the Action for Dental Health is to provide care now to people who are suffering.”

The measures are programmatic measures and are meant for use by the Medicaid programs and health plans to identify the extent to which their enrolled population uses the ER inappropriately. Overcoming this problem will require programs and plans to encourage patients to seek timely preventive and restorative care within office settings. In addition to evaluating ER measures, the DQA will continue its work in validating new oral health measures, thanks to a grant from the ADA Foundation.

“We’re seeing an increasing focus on quality measurement in both Medicaid programs and in emerging marketplaces,” said Dr. Jim Crall, DQA chair-elect. “This shows us how important the work of the DQA is and reaffirms that we need to continue moving forward to develop and promote measures that can help guide improvements in oral health care programs.”

This year, the DQA will look into measures for adults. For more information, visit the DQA website.

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