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私营部门为牙科服务支付的自付费用-来自奥地利的实证证据。

Out-of-pocket expenditure by private households for dental services - empirical evidence from Austria.

机构信息

Department of Economics and Statistics, University of Innsbruck, Universitätsstrasse 15, A-6020, Innsbruck, Austria.

出版信息

Health Econ Rev. 2016 Dec;6(1):10. doi: 10.1186/s13561-016-0087-5. Epub 2016 Mar 5.

Abstract

AIMS

Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services-especially costs beyond routine dental treatment-is paid directly by the patient out-of-pocket.

SETTINGS AND DESIGN

This study analyses the socio-economic determinants of out-of-pocket expenditure for dental services (OOPE) in Austria at the household level.

METHODS AND MATERIAL

Cross-sectional information on OOPE and household characteristics provided by the Austrian household budget survey 2009/10 was analysed.

STATISTICAL ANALYSIS USED

A two-part model (Logit/GLM) and one-part GLM was applied.

RESULTS

The probability of OOPE is strongly affected by the life cycle (structure) of the household. It is higher for higher age classes, higher income, and partially higher levels of education. The type of public insurance has an influence on expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage, the covariates of the second stage remain predominantly insignificant. According to the results, the level of expenditure is driven mainly by the level of education and income. The results of the one-part GLM confirm the results of the two-part model.

CONCLUSIONS

The results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although caution should be applied before jumping to conclusions for the individual level.

摘要

目的

牙科服务在几个方面与其他卫生服务不同。一个重要的区别是,牙科服务的相当一部分费用——特别是超出常规牙科治疗的费用——是由患者自费直接支付的。

背景和设计

本研究分析了奥地利家庭层面牙科服务自费支出(OOPE)的社会经济决定因素。

方法和材料

分析了 2009/10 年奥地利家庭预算调查提供的关于 OOPE 和家庭特征的横截面信息。

统计分析方法

采用两部分模型(Logit/GLM)和一部分 GLM 进行分析。

结果

自费支出的概率受到家庭生命周期(结构)的强烈影响。年龄较大、收入较高和部分教育水平较高的家庭,自费支出的概率更高。公共保险的类型对支出概率有影响,而私人健康保险的存在则没有显著影响。与第一阶段高度显著的系数相比,第二阶段的协变量主要不显著。根据结果,支出水平主要由教育程度和收入驱动。一部分 GLM 的结果证实了两部分模型的结果。

结论

这些结果为牙科保健自费支出的决定因素提供了新的见解。家庭层面被证明是研究自费支出决定因素的适当基础,尽管在得出个人层面的结论之前应谨慎行事。

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