Manski Richard, Moeller John, Chen Haiyan, Widström Eeva, Lee Jinkook, Listl Stefan
Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD, USA.
Int Dent J. 2015 Apr;65(2):77-88. doi: 10.1111/idj.12139. Epub 2014 Nov 1.
Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental-care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the USA and various European countries.
The analyses relied on 2006-2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and on 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents 51 years of age and older. A series of logistic regression models was estimated to identify disparities in dental coverage.
The highest extent of significant insurance differences between various population subgroups was found for the USA. In comparison with southern and eastern European countries, a lower number of significant differences in coverage was found for Scandinavian countries. Countries categorised as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than did countries categorised as not having comprehensive public coverage. The exceptions were Poland and Switzerland.
The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and that the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies in order to provide more equitable dental coverage.
预防和治疗口腔疾病费用的保险可以减少牙科护理使用和口腔健康方面的不平等。本研究的目的是调查美国和欧洲各国国内以及各国之间老年人群体牙科保险覆盖范围的差异程度。
分析依赖于欧洲健康、老龄化和退休调查(SHARE)2006 - 2007年的数据以及美国健康与退休研究(HRS)2004 - 2006年的数据,研究对象为51岁及以上的受访者。估计了一系列逻辑回归模型以确定牙科保险覆盖方面的差异。
在美国,各人群亚组之间保险差异显著的程度最高。与南欧和东欧国家相比,斯堪的纳维亚国家在保险覆盖方面的显著差异数量较少。被归类为拥有全面公共保险覆盖的国家,其人口内部保险差异的趋势比未被归类为拥有全面公共覆盖的国家要小。波兰和瑞士是例外。
本研究结果表明,在所研究的所有老年人群体中,牙科保险覆盖存在显著差异,而且各国之间不平等的程度也有所不同。总体而言,观察到的差异证实了这样一种看法,即在公共补贴下,人群牙科保险覆盖分布更为均衡。这对于寻求改进政策以提供更公平牙科保险覆盖的决策者来说可能是相关信息。