INSERM, U912 (SE4S), Marseille, France.
Health Policy. 2011 Dec;103(2-3):160-7. doi: 10.1016/j.healthpol.2011.09.011. Epub 2011 Oct 21.
To examine the relations between density of dental practitioners (DDP) and socio-economic and demographic factors shown to affect access to dental care for the elderly.
Data are taken from a cross-sectional survey - 2008 Disability Healthcare - Household section Survey (HSM). HSM is a representative random sample of French people living in their own domiciles. Our study focuses on the 9233 individuals aged 60 years and above. Multilevel models are employed to disentangle the relations between the determinants of dental care utilisation and DDP. Statistical analyses are conducted using SAS 9.2 and HLM 6.
Low-income and lack of complementary health insurance are associated with higher odds of not having visited a dentist, revealing a high unequal access to dental care. By using multilevel modelling, DDP appears to be a significant factor to access to dental services. When considering the intricate relations between income gradient and DDP, the latter lessens the income-related inequality to access dental services.
DDP seems favouring a more equitable access to dental care, mitigating under-caring of the poorest. This point is to be added in the debate about density of healthcare suppliers.
研究牙医密度（DDP）与社会经济和人口因素之间的关系，这些因素被认为会影响老年人获得牙科保健的机会。
数据来自一项横断面调查——2008 年残疾医疗保健——家庭部分调查（HSM）。HSM 是居住在自有住所的法国人的代表性随机样本。我们的研究集中在 9233 名 60 岁及以上的人。使用多层次模型来理清牙科保健利用的决定因素与 DDP 之间的关系。使用 SAS 9.2 和 HLM 6 进行统计分析。
低收入和缺乏补充健康保险与看牙医的几率较高相关，这表明牙科保健的机会不平等程度较高。通过使用多层次模型，DDP 似乎是获得牙科服务的重要因素。在考虑收入梯度和 DDP 之间复杂的关系时，后者减轻了与收入相关的获得牙科服务的不平等。
DDP 似乎有利于更公平地获得牙科保健，减轻了最贫困人群的医疗不足。这一点需要在关于医疗保健供应商密度的辩论中加以补充。
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