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在安大略省,提供牙科保险可以对口腔健康结果产生积极影响。

Providing dental insurance can positively impact oral health outcomes in Ontario.

机构信息

Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada.

School of Dentistry, University of Birmingham, Birmingham, England.

出版信息

BMC Health Serv Res. 2020 Feb 17;20(1):124. doi: 10.1186/s12913-020-4967-3.

Abstract

BACKGROUND

Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population.

METHODS

We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013-2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada's most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups.

RESULTS

Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9-24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6-11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9-19.8 vs. ME lowest: 27.2; 95% CI: 25.0-29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: - 13.2 to - 9.9 vs. ME lowest: -27.2; 95% CI: - 29.5 to - 24.8).

CONCLUSIONS

Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

摘要

背景

在加拿大,普及牙科保健是一个热门的政策议题,但在该人群中,牙科保险对改善与口腔健康相关结果的影响仍缺乏经验证据。

方法

我们利用加拿大 2013-2014 年社区健康调查中年龄在 12 岁及以上人群的数据,估计在加拿大人口最多的省份安大略省拥有牙科保险的个体(n=42553 人,代表 11682112 名安大略省居民)的牙科就诊行为和口腔健康状况结局的边际效应(ME)。我们使用多变量逻辑回归模型来估计牙科就诊行为和口腔健康状况结局的 ME。我们还研究了保险在收入、教育和年龄亚组中的 ME。

结果

拥有牙科保险增加了过去一年就诊牙医的参与者比例(56.6%至 79.4%,ME:22.8,95%置信区间(CI):20.9-24.7)和报告口腔健康状况非常好或极好的参与者比例(48.3%至 57.9%,ME:9.6,95%CI:7.6-11.5)。与收入最高的群体相比,收入最低的群体拥有牙科保险对牙科就诊行为的 ME 更大:过去 12 个月内的牙科就诊(ME 最高:17.9;95%CI:15.9-19.8 vs. ME 最低:27.2;95%CI:25.0-29.3)和仅因紧急情况就诊(ME 最高:-11.5;95%CI:-13.2 至-9.9 vs. ME 最低:-27.2;95%CI:-29.5 至-24.8)。

结论

研究结果表明,牙科保险与改善牙科就诊行为和口腔健康状况结局有关。政策制定者可以考虑普及牙科保险作为支持经济弱势群体和减少贫富之间口腔健康差距的一种手段。

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Dental visiting by insurance and oral health impact.保险覆盖的看牙次数与口腔健康影响。
Aust Dent J. 2013 Sep;58(3):344-9. doi: 10.1111/adj.12082. Epub 2013 Jul 31.

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