Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; North American Observatory on Health Systems and Policies.
North American Observatory on Health Systems and Policies; Faculty of Dentistry, University of Toronto, Canada.
Health Policy. 2020 Sep;124(9):998-1007. doi: 10.1016/j.healthpol.2020.06.015. Epub 2020 Jul 2.
Oral health is an important component of general health, yet there is limited financial protection for the costs of oral health care in many countries. This study compares public dental care coverage in a selection of jurisdictions: Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States. Drawing on the WHO Universal Coverage Cube, we compare breadth (who is covered), depth (share of total costs covered), and scope (services covered), with a focus on adults aged 65 and older. We worked with local experts to populate templates to provide detailed and comparable descriptions of dental care coverage in their jurisdictions. Overall most jurisdictions offer public dental coverage for basic services (exams, x-rays, simple fillings) within four general types of coverage models: 1) deep public coverage for a subset of the older adult population based on strict eligibility criteria: Canada (Alberta), Australia (New South Wales) and Italy; 2) universal but shallow coverage of the older adult population: England, France, Sweden; 3) universal, and predominantly deep coverage for older adults: Germany; and 4) shallow coverage available only to some subgroups of older adults in the United States. Due to the limited availability of comparable data within and across jurisdictions, further research would benefit from standardized data collection initiatives for oral health measures.
口腔健康是总体健康的一个重要组成部分，但在许多国家，口腔保健费用的财政保障有限。本研究比较了一些司法管辖区的公共牙科保健覆盖范围：澳大利亚（新南威尔士州）、加拿大（艾伯塔省）、英格兰、法国、德国、意大利、瑞典和美国。本研究借鉴世界卫生组织的全民覆盖魔方，比较了广度（谁被覆盖）、深度（总费用覆盖的比例）和范围（覆盖的服务），重点是 65 岁及以上的成年人。我们与当地专家合作，填写模板，详细描述其司法管辖区的牙科保健覆盖情况，并进行比较。总体而言，大多数司法管辖区都为基本服务（检查、X 光、简单补牙）提供公共牙科覆盖，涵盖以下四种一般类型的覆盖模式：1）根据严格的资格标准，为一部分老年人口提供深度公共覆盖：加拿大（艾伯塔省）、澳大利亚（新南威尔士州）和意大利；2）对老年人口普遍但浅层的覆盖：英格兰、法国、瑞典；3）对老年人口普遍且主要是深度覆盖：德国；4）仅为美国一些老年亚组提供浅层覆盖。由于各司法管辖区内和之间可比数据的有限可用性，进一步的研究将受益于口腔健康措施的标准化数据收集倡议。
