Kim Nayoung, Kim Chang-Yup, Shin Hosung
Department of Postanesthetic Care Unit, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
Department of Health Policy and Management, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, 151-742, Seoul, Korea.
BMC Oral Health. 2017 Apr 26;17(1):80. doi: 10.1186/s12903-017-0370-9.
The current public health research agenda was to identify the means to reduce oral health inequalities internationally. The objectives of this study were to provide evidence of inequality in unmet dental needs and to find influencing factors attributable to those among South Korean adults.
Pooled cross-sectional data from the fourth Korean National Health and Nutrition Examination Survey (2007-2009) on 17,141 Korean adults were used. Demographic factors (sex, age, and marital status), socioeconomic factors (education level, employment status, and income level), need factors (normative dental needs and self-perceived oral health status), and oral health-related factors (the number of decayed teeth, the presence of periodontitis, and the number of missing teeth) were included. Multiple logistic regression analysis was performed.
Of South Korean adults, 43.9% had perceived unmet dental needs, with the most common reason being financial difficulties. The disparities in unmet dental care needs were strongly associated with income level, normative treatment needs, and self-perceived oral health status. The low-income group, people with normative dental treatment needs, and those with perceived poor oral health status were more likely to have unmet dental needs. There was considerable inequality in unmet dental care needs due to economic reasons according to such socioeconomic factors as income and education level.
Public health policies with the expansion of dental insurance coverage are needed to reduce inequalities in unmet dental care needs and improve the accessibility of dental care services to vulnerable groups who are experiencing unmet dental care needs due to socioeconomic factors despite having normative and self-perceived needs for dental treatment.
当前的公共卫生研究议程旨在确定在国际上减少口腔健康不平等的方法。本研究的目的是提供未满足的牙科需求方面不平等的证据，并找出韩国成年人中导致这些不平等的影响因素。
使用了来自韩国第四次全国健康与营养检查调查（2007 - 2009年）的17141名韩国成年人的汇总横断面数据。纳入了人口统计学因素（性别、年龄和婚姻状况）、社会经济因素（教育水平、就业状况和收入水平）、需求因素（标准牙科需求和自我感知的口腔健康状况）以及口腔健康相关因素（龋齿数量、牙周炎的存在情况和缺牙数量）。进行了多元逻辑回归分析。
在韩国成年人中，43.9%的人认为存在未满足的牙科需求，最常见的原因是经济困难。未满足的牙科护理需求差异与收入水平、标准治疗需求和自我感知的口腔健康状况密切相关。低收入群体、有标准牙科治疗需求的人以及那些自我感知口腔健康状况较差的人更有可能有未满足的牙科需求。根据收入和教育水平等社会经济因素，由于经济原因，未满足的牙科护理需求存在相当大的不平等。
需要制定扩大牙科保险覆盖范围的公共卫生政策，以减少未满足的牙科护理需求方面的不平等，并提高牙科护理服务对弱势群体的可及性，这些弱势群体尽管有标准的和自我感知的牙科治疗需求，但由于社会经济因素而存在未满足的牙科护理需求。
