Assessing the Causal Impact of Delayed Oral Health Care on Emergency Department Utilization

This study examines the causal effect of delayed oral health care on increased emergency department visits in the United States. We extend prior research by estimating the effect of delayed or forgone preventive and necessary dental care on emergency department utilization using a longitudinal, nationally representative data set. We incorporate the temporal structure of the data into a two-part model with a predictive component and an inferential component. The first part predicts propensity scores for delayed oral health care and the second stage incorporates the inverse weighted propensity scores in a logistic regression that assesses nationally representative estimates of any emergency department visits. We find a positive causal relationship between delaying oral health care and subsequent emergency department utilization. Our results have implications for actuaries, policymakers, and consumers, because unnecessary use of emergency department services for preventable conditions is a growing public health concern in the United States.