The root of prob­lem the

With Cover the Unin­sured Week un­der way, Caroli­nas bat­tle with ac­cess, pre­ventable ER vis­its—even of the den­tal va­ri­ety

Modern Healthcare - - Cover Story - Re­becca Ve­sely

In Spar­tan­burg County, S.C., one in 10 adults doesn’t have any teeth.

It’s a shock­ing statis­tic that lo­cal providers learned just last year when they be­gan as­sess­ing bar­ri­ers to care among low-in­come unin­sured. “We asked, ‘How is this pos­si­ble?’ ” said Re­nee Romberger, vice pres­i­dent of com­mu­nity health pol­icy and strat­egy at Spar­tan­burg (S.C.) Re­gional Health­care Sys­tem.

As the only safety net hospi­tal in the county, not-for-profit Spar­tan­burg Re­gional spent about $1 mil­lion last year on un­re­im­bursed emer­gency den­tal care.

But of­fi­cials there didn’t know the ex­tent of the prob­lem the unin­sured face in terms of den­tal care and other un­met health needs un­til they em­barked on a com­mu­ni­ty­wide as­sess­ment of lo­cal health ser­vices.

They learned that there are no adult den­tal providers for the unin­sured in the county. About once a month, a den­tist vis­its a home­less cen­ter in the area and does tooth ex­trac­tions free of charge. Tooth-pulling is, for many unin­sured, the only low-cost so­lu­tion to the painful, chronic prob­lem of tooth de­cay.

The dire need for adult den­tal care isn’t iso­lated to Spar­tan­burg, a ru­ral county near the North Carolina bor­der.

Un­treated tooth de­cay is the No. 1 rea­son for pre­ventable emer­gency room vis­its in South Carolina’s ru­ral coun­ties among unin­sured adults aged 18 to 64. In South Carolina over­all, den­tal care is the third most com­mon rea­son why unin­sured adults visit ERs.

“This was not some­thing we ex­pected,” said Amy Martin, deputy di­rec­tor of the South Carolina Of­fice of Ru­ral Health, at the Uni­ver­sity of South Carolina. “Den­tal is a huge un­met need. It’s not a high-dol­lar ER visit, but it’s a high-vol­ume ER visit.”

Providers rec­og­nized im­me­di­ately that the den­tal cri­sis in the re­gion re­ver­ber­ates through the lo­cal econ­omy.

“It’s very hard to get a job if you don’t have teeth,” Martin said. With the man­u­fac­tur­ing, tex­tile and to­bacco sec­tors shrink­ing, tourism has be­come a lead­ing jobcre­ator in South Carolina. But no­body in the tourism in­dus­try wants to hire work­ers without teeth, Martin said. “Adult den­tal care is so im­por­tant from an eco­nomic stand­point,” Martin said. “But there has been a cer­tain hope­less­ness around adult den­tal.”

Now, some providers in the Caroli­nas are work­ing to­gether to turn that hope­less­ness around.

They are em­bark­ing on a new, co­or­di­nated push to serve the unin­sured, thanks to longterm sup­port from the Duke En­dow­ment in Char­lotte, N.C., and the South Carolina Hospi­tal As­so­ci­a­tion, among oth­ers.

Martin: Den­tal is “not a high-dol­lar ER visit,” but it’s high-vol­ume.

Me­lanie Mat­ney, ex­ec­u­tive di­rec­tor of Ac­cessHealth SC, says the goal is to cre­ate net­works of care to im­prove ac­cess.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.