Dental Surgeries in Hospitals and Surgery Centers for Children With Developmental Disabilities

Background and Objective

Children with intellectual disabilities and related conditions (IDRC) and autism often require dental treatment in surgical settings. Studies of older adults suggest that ambulatory surgery centers (ASCs) can reduce costs without reducing quality, but it is unknown whether this is true for children with autism and IDRC and dental surgeries. This study compared outcomes among children with IDRC and autism receiving dental caries-related surgeries at ASCs and hospital outpatient departments (HOPDs).

Methods

This cross-sectional analysis used Medicaid data from 29 states (2016-2020) to examine 17,552 outpatient dental surgeries in ASCs and HOPDs for children with IDRC or autism. Regression models were used to examine whether outcomes varied by setting of care (ASC vs HOPD). The following outcomes were included: days from diagnosis to surgery, Medicaid payment, emergency department (ED) visits, and hospitalization after surgery.

Results

Multivariate regression results indicate time from diagnosis to surgery was, on average, 8.7 days sooner for a child with autism and 13.2 days sooner for a child with IDRC if furnished in an ASC compared with a HOPD (P < .001 for both). Average Medicaid payment was $419 and $363 less in an ASC than HOPD for a child with autism (P = .003) or IDRC (P = .02), respectively. The likelihood of an ED visit or hospitalization was lower in an ASC than HOPD for a child with IDRC (P < .001), but not autism (P > .05).

Conclusions

Increasing use of ASCs for dental care may increase timely receipt of care and lower Medicaid costs without increasing adverse outcomes for children with autism and IDRC.