Manski Richard, Moeller John, Chen Haiyan, Widström Eeva, Listl Stefan
Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD, USA.
National Institute for Health and Welfare, Helsinki, Finland.
Int Dent J. 2016 Feb;66(1):36-48. doi: 10.1111/idj.12190. Epub 2015 Oct 14.
The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries.
The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents≥51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use.
We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social health insurance.
The findings of this study suggest that income and education have a stronger, and more persistent, correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that: (i) higher overall rates of coverage in most European countries, compared with relatively lower rates in the USA, contribute to this finding; and that (ii) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services.
本研究探讨了美国和部分欧洲国家内部及之间不同人群亚组在牙科就诊方面的差异程度。
分析所依据的数据来自欧洲健康、老龄化与退休调查(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,受访者年龄≥51岁。估计逻辑回归模型以确定牙科护理覆盖范围以及口腔和总体健康状况对牙科护理使用的影响。
我们无法辨别在有无社会医疗保险的国家之间、美国与欧洲国家之间以及根据社会福利制度分类的欧洲国家之间,不同人群亚组在牙科就诊方面存在显著差异。发现了不同的牙科使用模式,但它们并非主要出现在根据福利国家制度或有无社会医疗保险分类的国家中。
本研究结果表明,在欧洲国家,收入和教育与牙科使用的相关性比牙科保险与牙科使用的相关性更强且更持久。我们得出以下结论:(i)与美国相对较低的覆盖率相比,大多数欧洲国家总体覆盖率较高促成了这一结果;以及(ii)在欧洲和美国,旨在提高老年人收入及其对口腔保健重要性认识的政策有助于改善牙科服务的使用。