Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Patumwan, Bangkok, Thailand.
Int Dent J. 2009 Dec;59(6):349-57.
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.
The data to perform analyses were taken from the nationally representative Health and Welfare Survey (HWS) and Socioeconomic Survey (SES) 2007 in Thailand.
Data of 15,736 representative Thai children (aged below 15 years) were selected.
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.
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.
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.
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。
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。
选择了 15736 名有代表性的泰国儿童(年龄在 15 岁以下)的数据。
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。
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。
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。