Pneumonia affects almost a million people in the general population per year in the United States. Pneumonia is thought to be due to aspiration of oral pathogens into the respiratory tract of a susceptible host. Lack of access to dental services may correspond to an increased risk of pneumonia.
The Medical Expenditure Panel Survey (MEPS) provides national data on healthcare utilization, costs, and patient satisfaction. Data was obtained from the 2013 survey including social and demographic factors, and dental care indicators.
Missing responses were omitted from analysis. A diagnosis of bacterial pneumonia in 2013 was analyzed for associations with various covariates using simple and multiple logistic regression. The multiple logistic model was determined using backward selection with a p-to-stay of 0.2. Variance inflation factors were used to assess for multicollinearity. All statistics were calculated accounting for a complex sampling design with MEPS 2013 specific population weights.
In 2013, 441 individuals experienced at least one episode of pneumonia (1.68% of the sample), while 26,246 did not.
In the multivariable model, white race, increasing age, increasing Charlson Comorbidity Index, and worse perceived health status were significantly associated with increasing pneumonia risk when controlling for each of these variables, dental care indicators of insurance, and frequency of dental check-ups. Of the dental variables, frequency of dental check-ups remained significantly associated with pneumonia; those never attending dental check-ups had an 86% increased risk of pneumonia compared to those with check-ups twice yearly (95%CI: 1.30,2.65, p=0.0008). Dental insurance, despite its association with pneumonia on bivariate analysis, was not significantly associated with pneumonia risk in the adjusted model (p=0.9394). There was no evidence of multicollinearity.
Pneumonia risk appears to be decreased in those who customarily attend routine dental check-ups. This is consistent with data that good oral health is an important component of overall health. Dental insurance was not associated with pneumonia in the final model; insurance alone may be insufficient to guarantee access to dental care.
S. Ratliff, None
N. Carroll, None
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