166 - Access to Care for Underinsured Pediatric Patients in Dallas TX

Purpose: To analyze the financial demographics and ASA classification for children requiring advanced behavior guidance under general anesthesia for dental treatment

Methods: A retrospective cohort study using Epic EHR was performed to analyze charts for pediatric patients who received dental treatment under GA at Children’s Health Main Dallas OR between 01/01/2022 – Present. Each chart was reviewed for inclusion and exclusion criteria. Data was collected regarding the date of surgery, surgery location and provider, medical history, ASA classification, and payor source.

Results: 9285 dental surgeries were performed during the study period. The following is the breakdown of insurances for those cases: 149 CMC Financial Discount Plan, 7159 Medicaid, 101 Superior Foster Care, 19 CSHCN Medicaid, 1566 Commercial insurance, 4 Medicare, 153 CHIP, 53 Tricare/Military, and 81 had no insurance listed. ASA 2 patients dominated in number for almost all payor sources. ASA 3 patients were the second highest in number for three payor sources. The level of ASA 3 and ASA 4 patients has been stable over the last four years. However, 32.3% of patients that qualified for the CMC Financial Discount Plan are more medically compromised. 15% of Superior Foster Care patients and 24% of CHIP patients were ASA 3 or 4.

Conclusions: Many patients require dental treatment in the OR yearly and often, these patients are underinsured. The most vulnerable patients (special healthcare needs) have difficulty accessing dental care. A more complete picture may be gained by a larger sample size and from a variety of institutions.