Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, Iksan, North Jula, Republic of Korea.
Department of Dental Hygiene, Kyungbok University, Pocheon, Gyeoggi, Republic of Korea.
PLoS One. 2018 Sep 7;13(9):e0203640. doi: 10.1371/journal.pone.0203640. eCollection 2018.
The aim of the present study was to assess the regional deprivation and individual factors that influence how far a person will travel to access dental care. Using data from the Korea Health Panel (2008 to 2011), we selected a group of 4,256 subjects and geocoded their homes and dental hospitals/clinics. Using the road network analysis, we calculated the distance traveled by the subjects for dental care. We used the generalized estimating equation (GEE) for repeated data analysis and included an interaction term between regional deprivation and individual income to determine the effects of the two factors on the choice of a dental hospital/clinic. When the regional deprivation index was divided into three quarters (high, middle, and low), urban areas had higher"high" and "low" levels of deprivation, and rural areas had relatively higher middle level of deprivation. GEE regression showed that the level of education, regional deprivation level, and income all affected the distance traveled to dental clinics. The regional deprivation level had a higher association than income with the travel distance. At the same income level, subjects who lived in the least deprived areas were more likely to travel longer distances than subjects living in the most deprived areas. Regarding the distribution of dental hospitals/clinics, incentive based dental polices for either dental providers or patients are needed that will assure the delivery of dental care despite spatial inequality.
本研究旨在评估地区贫困程度和个人因素对人们就医距离的影响。我们使用韩国健康面板(2008 年至 2011 年)的数据,选取了 4256 名研究对象,并对他们的家庭和牙科医院/诊所进行了地理编码。通过路网分析,我们计算了研究对象为看牙而出行的距离。我们使用广义估计方程(GEE)对重复数据进行分析,并在地区贫困程度和个人收入之间加入了交互项,以确定这两个因素对牙科医院/诊所选择的影响。当地区贫困指数被分为三个部分(高、中、低)时,城市地区的“高”和“低”贫困程度更高,而农村地区的中等贫困程度相对较高。GEE 回归分析显示,教育程度、地区贫困程度和收入都影响着前往牙科诊所的距离。地区贫困程度比收入与出行距离的相关性更高。在相同的收入水平下,生活在贫困程度最低地区的研究对象比生活在贫困程度最高地区的研究对象更有可能出行更远的距离。关于牙科医院/诊所的分布,需要制定基于激励的牙科政策,无论是针对牙科提供者还是患者,以确保在存在空间不平等的情况下提供牙科保健服务。