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Oral health has been connected to worse outcomes among hospitalized patients, but access to oral health care services in the hospital setting is limited. It is unknown how a hospital admission affects subsequent dental services use. The authors conducted a retrospective analysis of insurance claims data from a national private insurer. Patients were included if they were admitted to the hospital and had visited a dentist at least once in the year before or after admission. Total number of dental visits, as well as Code on Dental Procedures and Nomenclature codes associated with these visits in the year before and after a hospital stay, patient demographic characteristics, hospital admission diagnosis, and length of stay were recorded. Differences in dental services use before and after the hospital stay were calculated. In total, 107,116 patients met inclusion criteria. There were fewer dental visits after admission (mean [standard deviation {SD}] 1.6 [1.7] than before admission (mean [SD] 1.9 [1.8]; P <.0001). Fewer procedures were recorded in the year after discharge (mean [SD] 7.0 [11.4] total Code on Dental Procedures and Nomenclature codes versus 8.5 [12.5] in the year before admission; P <.0001). The number of diagnostic and restorative services delivered was higher after admission, and the number of periodontic, endodontic, oral surgery, and prosthodontic services decreased (overall Pearson χ2, P <.0001). Patients are less likely to visit a dentist after a hospital stay, although impact on oral health is unknown. Hospitalization may contribute to already existing oral health disparities. Hospital teams and dentists should work together to enhance access to oral health care after hospital admission. [ABSTRACT FROM AUTHOR]

The United States has a high incarceration rate. Incarceration is associated with increased risk for cancer, chronic illness, serious mental illness, and substance use disorder. People who are incarcerated are less likely to be offered or participate in advance care planning, less likely to document their treatment preferences, and might not have a surrogate if one is needed. This article explores medical decision making for patients who are incarcerated and unrepresented and considers advantages and disadvantages of different classes of decision makers for them. [ABSTRACT FROM AUTHOR]

Unmet dental need shares many risk factors with unmet health-related social needs (HRSN) such as housing and food security and are a common cause for seeking treatment at the emergency department (ED). The authors recruited a purposive sample of English-speaking and Spanish-speaking patients, ED clinicians at 3 urban EDs, and dentists from nearby communities to participate in qualitative interviews to explore barriers to and facilitators of screening for HRSN and unmet dental needs in the ED. Themes were identified from transcripts using a modified grounded theory approach. Interviews were conducted with 25 ED patients, 19 ED clinicians, and 4 dentists. Four themes were identified: (1) a preference for formalized resources, which more frequently exist for HRSN than for oral health; (2) frequent use of ad hoc resources that are less reliable or structured, particularly for dental referral information; (3) limited knowledge of oral health care resources in the community; and (4) desire for more assistance with identifying and addressing resource needs for both HRSN and oral health. Patients were amenable to screening through a variety of modalities and felt it would be helpful, but clinicians emphasized the need for easier referral processes because of frequent failure to connect patients to oral health care. More robust infrastructure and clinician support are needed to ensure successful referral and screening without undue provider burden for both medical and dental clinicians. Patients are amenable to screening for unmet oral health needs and HRSN in the ED, which may improve access to care. [ABSTRACT FROM AUTHOR]

The article offers information on the collaborative approach funded by the Health Foundation for Western & Central New York, where health and social-service organizations work together to develop best pratices and cordination of services for popultions. It mentions that the organizations work together to support the patients and social service.

Many objective measures rating quality of doctors, hospitals, and medical groups are publicly reported. Surgical patients may have more opportunity to use quality measures than other types of patients to guide their choice of provider. If surgical patients are able to choose higher quality providers, overall surgical quality might increase.To determine what procedure-specific measures of surgical quality are available to consumers facing surgery in California and what new measures will be available by 2005. We searched for and surveyed organizations publicly reporting data on health care quality in California. We asked about current quality measures and new measures set for public release by 2005. Included measures had to be procedure-specific and results separated by hospital. The main outcome measures were the number of quality measures; conceptual aspect of quality measured; and type of risk-adjustment used.Eighteen organizations publicly report any health care quality measures in California. These organizations report 333 measures, of which 32 (10%) are procedure-specific measures of surgical quality. There is at least one quality measure for 21 different procedures; these procedures account for 14% of all major operations. Three new measures will be released by 2005.Californians facing surgery have limited information regarding quality of their care; few new measures are planned. Eighty-six per cent of patients would find no quality measures related to planned procedures. Public release of performance data is unlikely to improve the quality of health care unless the number and comprehensiveness of measures increase dramatically. [ABSTRACT FROM AUTHOR]

The article offers information on a study which aims at evaluating whether discharge against medical advice (DAMA) was associated with a history of criminal legal involvement (CLI) among patients at a large urban tertiary care medical center in the northeastern U.S. It states that DAMA charts were reviewed for variables including demographics, medical history, behavioral health history, social history, and history of CLI.

An editorial is presented which addresses the authors' views about integrated care delivery models involving oral health and medicine in America as of 2017, and it mentions the suffering that is associated with poor oral health and dental problems such as painful, cracked, and missing teeth. Social inequality in the U.S. is addressed, along with dental and medical care costs in the country. Dentist-patient relations and dental insurance coverage are also assessed.

A personal narrative is presented which explores the author's experience of contracting hypothermia when she was 18 years old after she went camping in the snow.