MEDICAL CLAIMS PROFILES OF SUBJECTS WITH TEMPOROMANDIBULAR-JOINT DISORDERS

The primary goal of this study was to evaluate the claims profiles of subjects with TMJ disorders relative to a control group without the di sorders and to provide a characterization of the type of healthcare se rvices received and the associated costs of healthcare for patients wi th TMJ disorders. The administrative data base of a major medical insu rer was used to compare the claims history of 1,819 patients diagnosed with TMJ disorders to matched controls, The analysis was based only o n medical claims. The study found that total medical claim payments fo r the patients with TMJ disorders were double that of the subjects wit hout TMJ disorders, and similarly, the utilization of institutional an d professional care services was found to be approximately twice as hi gh, though not uniformly distributed across all Major Diagnostic Categ ories, physician specialties or types of service. The level and nature of the differences in the quantity and costs of healthcare between su bjects with and without TMJ disorders were unexpectedly large. The maj ority of these differences were attributed to conditions that were not usually considered related to TMJ disorders. These utilization and co st differences extended, in varying degrees, over a wide range of diag nostic and healthcare provider categories.