{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T15:38:17Z","timestamp":1792337897624,"version":"4.4.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Monitoring hospitalization rates associated with oral health conditions is an important part of epidemiological surveillance, especially when these conditions have increased significantly in low\u2014and middle-income countries. This study aimed to evaluate the temporal trends in hospital discharges associated with oral health-related conditions in Ecuador from 2000 to 2023 and identify the leading diagnoses groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>An ecological time-series study was conducted based on annual data from the National Institute of Statistics and Censuses of Ecuador. We identified oral conditions using hospital discharge records, which were classified according to the International Classification of Diseases. We estimated crude and age-standardized rates per 100,000 inhabitants for the entire population and crude rates by sex, age, region, and the diagnosis. Joinpoint analysis was used to identify national trends in hospital discharges.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 93652 hospitalizations were identified. Malignant tumors of the head, face, and neck were the most common diagnosis attributed to hospital discharges (16.5%), followed by cleft palate (14.5%) and cleft lip (7.8%) and other diseases of the jaws (5.4%). The crude rate of OHRC increased from 17.94 to 28.81 hospitalizations per 100,000 population between 2000 and 2023. Based on joinpoint analysis, hospital discharges increased by 2.2% annually during the study period. However, three temporal trends were identified: from 2000 to 2017, hospital discharges increased annually by 4.3% (p&lt;0.05); from 2017 to 2020 decreased by 17.2%; and from 2020 to 2023 increased annually by 12.9%. Average hospitalization rates were higher among those aged 0\u20139 and &gt; 64 years.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Hospitalization rates associated with oral health-related conditions in Ecuador have increased significantly over the past twenty-four years, except during the COVID-19 pandemic, where cases dropped considerably. Many of the oral conditions identified in the study were malignancies, which are caused by a complex relationship between genetic, environmental, and behavioral factors. Conducting early detection analysis is essential to reduce their occurrence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0317440","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T18:31:27Z","timestamp":1738002687000},"page":"e0317440","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Oral health-related conditions in Ecuador: A temporal trend analysis of hospital discharges from 2000\u20132023"],"prefix":"10.1371","volume":"20","author":[{"given":"Ver\u00f3nica","family":"Balde\u00f3n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sthephany","family":"Tapia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-0331","authenticated-orcid":true,"given":"Alejandro","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"pone.0317440.ref001","volume-title":"Regional summary of the Region of the Americas [Internet].","author":"World Health 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Sanmarquina"},{"key":"pone.0317440.ref015","article-title":"GNI per capita [Internet].","author":"The World Bank","year":"2020"},{"key":"pone.0317440.ref016","first-page":"52","article-title":"Pa\u00eds atrevido: la nueva cara sociodemogr\u00e1fica del Ecuador.","author":"B Villac\u00eds","year":"2012","journal-title":"Edic\u00f3n Espec Rev Anal Inst Nac Estad\u00edstica y Censos [Internet]"},{"issue":"SUPPL. 2","key":"pone.0317440.ref017","first-page":"177","article-title":"Sistema de salud de Ecuador.","volume":"53","author":"R Lucio","year":"2011","journal-title":"Salud Publica Mex"},{"key":"pone.0317440.ref018","first-page":"335","article-title":"Permutation tests for joinpoint regression with applications to cancer rates. 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Registro Estad\u00edstico de Recursos y Actividades de Salud: Documento Metodol\u00f3gicco [Internet]. Quito, Ecuador; 2018. Available from: https:\/\/www.ecuadorencifras.gob.ec\/documentos\/web-inec\/Estadisticas_Sociales\/Recursos_Actividades_de_Salud\/RAS_2017\/Documento_Metodologico_%28RAS%29.pdf"},{"issue":"1","key":"pone.0317440.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12903-019-0863-9","article-title":"Oral health of 12-year-old children in Quito, Ecuador: A population-based epidemiological survey.","volume":"19","author":"E Michel-Crosato","year":"2019","journal-title":"BMC Oral Health"},{"key":"pone.0317440.ref028","first-page":"24","article-title":"The impact of the covid-19 pandemic on the provision of dental procedures performed by the brazilian unified health system: A syndemic perspective","author":"AR da Cunha","year":"2021","journal-title":"Rev Bras Epidemiol"},{"issue":"10","key":"pone.0317440.ref029","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.adaj.2023.07.012","article-title":"Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021.","volume":"154","author":"J Dill","year":"2023","journal-title":"J Am Dent Assoc"},{"issue":"2","key":"pone.0317440.ref030","first-page":"65","article-title":"C\u00e1ncer de la cavidad oral. Un reto para la salud de la poblaci\u00f3n mexicana en la pr\u00f3xima d\u00e9cada.","volume":"11","author":"JF Gallegos-Hern\u00e1ndez","year":"2012","journal-title":"Gac Mex Oncol [Internet]"},{"issue":"1","key":"pone.0317440.ref031","article-title":"Tend\u00eancias dos benef\u00edcios previdenci\u00e1rios por c\u00e2ncer bucal e de orofaringe de 2006 a 2013 no Brasil. 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An observational study illustrating the impact of administrative change.","volume":"25","author":"G Davie","year":"2019","journal-title":"Inj Prev [Internet]."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0317440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T18:31:41Z","timestamp":1738002701000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0317440"}},"subtitle":[],"editor":[{"given":"Ant\u00f3nio","family":"Machado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0317440","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]}}}