Manski Richard J, Macek Mark D, Moeller John F
Department of Oral Health Care Delivery, Dental School, University of Maryland, Baltimore 21201, USA.
J Am Dent Assoc. 2002 Nov;133(11):1551-9. doi: 10.14219/jada.archive.2002.0087.
Dental insurance has had a significant impact on dentistry and dental care use. Dental insurance coverage may influence people's decisions to use dental care. During 1996, 42.9 percent of all dental expenditures were paid by private dental insurance.
The focus of this analysis is on private dental coverage, use and expenditures for the U.S. civilian community-based population during 1996. The authors provide national estimates for the population with private dental coverage, the population with a dental visit, mean number of dental visits per year and mean total expenditures for several socioeconomic and demographic categories during 1996, using Medical Expenditure Panel Survey, or MEPS, data.
Poor and low-income people were less likely to have private dental coverage than were people with higher incomes. People without coverage at all income levels were less likely to report a dental visit than were people with coverage. When they controlled for coverage, the authors found that education at any income level did not appear to affect the likelihood of people's having multiple visits or higher expenditures.
People with private coverage are more likely to visit a dentist, have a greater number of visits and have higher expenditures than are those without coverage. Private dental insurance coverage, however, is not the only determinant of dental care use. MEPS data also show that other factors play key roles. Comprehensive strategies designed to improve dental care use should keep each of these determinants in mind.
While dentists may have a limited ability to influence people to seek care initially, they may be in a better position to influence the amount of care patients obtain, thereby helping make sure that patients receive the care that they need and want.
牙科保险对牙科及牙科护理的使用产生了重大影响。牙科保险覆盖范围可能会影响人们使用牙科护理的决定。1996年期间,所有牙科支出的42.9%由私人牙科保险支付。
本分析的重点是1996年美国以社区为基础的平民人口的私人牙科保险覆盖情况、使用情况和支出。作者利用医疗支出小组调查(MEPS)数据,提供了1996年几个社会经济和人口类别中拥有私人牙科保险的人口、进行过牙科就诊的人口、每年平均牙科就诊次数以及平均总支出的全国估计数。
贫困和低收入人群比高收入人群获得私人牙科保险的可能性更低。所有收入水平中未参保的人群比参保人群报告进行过牙科就诊的可能性更低。在控制了保险覆盖情况后,作者发现任何收入水平的教育程度似乎都不会影响人们进行多次就诊或支出更高费用的可能性。
与未参保人群相比,参保人群更有可能去看牙医、就诊次数更多且支出更高。然而,私人牙科保险覆盖并非牙科护理使用的唯一决定因素。MEPS数据还表明其他因素也起着关键作用。旨在改善牙科护理使用情况的综合策略应考虑到每一个决定因素。
虽然牙医在最初影响人们寻求护理方面的能力可能有限,但他们可能更有能力影响患者接受护理的数量,从而有助于确保患者获得他们需要和想要的护理。