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泰国儿童牙科保健利用不平等:来自已实现全民覆盖的泰国的证据。

Inequality in dental care utilisation among Thai children: evidence from Thailand where universal coverage has been achieved.

机构信息

Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Patumwan, Bangkok, Thailand.

出版信息

Int Dent J. 2009 Dec;59(6):349-57.


DOI:
PMID:20162947
Abstract

AIMS: To quantify the extent of the socioeconomic-related inequality in dental care utilisation among Thai children and to examine the characteristics of dental care utilisation, after the country achieved universal coverage. DESIGN: The data to perform analyses were taken from the nationally representative Health and Welfare Survey (HWS) and Socioeconomic Survey (SES) 2007 in Thailand. PARTICIPANTS: Data of 15,736 representative Thai children (aged below 15 years) were selected. METHODS: Descriptive analyses were performed to reveal the features of dental care utilisation among Thai children, in addition to use the concentration index (CI) to measure socioeconomic-related inequality in dental care utilisation. Logistic regression was employed to determine inequality in dental care across socioeconomic strata. RESULTS: The unequivocal gradient in dental care utilisation persistence among Thai children and the socioeconomic-related inequality in dental care utilisation is more concentrated among the better-off as the positive CI value (equals 0.069) emerged. Poor children, however, are more likely to utilise dental care at public facilities, particularly primary care facilities. CONCLUSION: The evidence from Thailand, where universal coverage has been virtually achieved, provides some lesson for other countries particularly developing countries. Although the socioeconomic-related inequality in dental care utilisation among Thai children still exists, the pro-poor dental care utilisation at public facilities, particularly primary care facilities substantiate the impressive stride towards the concerted effort to reducing inequitable dental care delivery for Thai children.

摘要

目的:量化泰国儿童牙科保健利用方面的社会经济相关不平等程度,并在该国实现全民覆盖后,考察牙科保健利用的特征。

设计:本分析所使用的数据取自泰国具有代表性的健康和福利调查(HWS)和社会经济调查(SES)2007 年的数据。

参与者:选择了 15736 名有代表性的泰国儿童(年龄在 15 岁以下)的数据。

方法:进行描述性分析以揭示泰国儿童牙科保健利用的特征,并使用集中指数(CI)来衡量牙科保健利用方面的社会经济相关不平等。采用逻辑回归来确定牙科保健在社会经济阶层之间的不平等情况。

结果:泰国儿童在牙科保健利用方面存在明确的梯度,而且牙科保健利用方面存在社会经济相关的不平等,这种不平等在较富裕阶层更为集中,因为正的 CI 值(等于 0.069)出现了。然而,贫困儿童更有可能在公共设施,特别是初级保健设施中利用牙科保健。

结论:在泰国,全民覆盖几乎已经实现,这为其他国家,特别是发展中国家提供了一些经验教训。尽管泰国儿童在牙科保健利用方面仍然存在社会经济相关的不平等,但在公共设施,特别是初级保健设施中,对贫困儿童的牙科保健利用倾向表明,为减少泰国儿童牙科保健服务提供方面的不公平现象,已取得了显著的进展。

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