Milén A, Laaksonen T, Halonen P
Centre for Training and Development, University of Kuopio, Finland.
Proc Finn Dent Soc. 1990;86(3-4):127-35.
In the Finnish programme of public oral health care for preschool children, every child is eligible for free care. The coverage of the programme has been high, about 85%. The aim of this study was to determine, whether the nonparticipants of the programme actually do have equality in making the choice to participate. The barriers to care were identified. All 4- to 6-year-old children who were registered administratively as nonparticipants in oral health care in 1981 and their randomly selected controls were studied in the city of Lahti. Detailed analysis of nonparticipation showed that some children had been misclassified as nonparticipants in the administrative statistics, indicating the national coverage of the programme to be higher than reported. Based on this finding, suggestions are made for increasing reliability of official statistics. Multiple logistic regression analysis for 36 factors resulted in three main barriers to utilization. Children of single-parent families in which the parent had a low level of education and difficulties to take time off work had the highest risk of nonutilization and thus had little choice to participate. Children with fear to dental care, regardless of any characteristic of the family or parents, were at increased risk of nonparticipation. Not having received the invitation to an examination also increased nonutilization, regardless of any factors related to family, parents or child. It was concluded, however, that these barriers to utilization could be manipulated by the system of public oral health care.
