School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran.
Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Oral Health. 2021 Oct 26;21(1):550. doi: 10.1186/s12903-021-01912-6.
Oral health is a major public health issue which affects the human life. Access to dental care is one of the important factors in maintaining oral health. This study was aimed to investigate inequality in dental care expenditure in Iranian households.
The present study is a secondary analysis of a national cross-sectional survey. The data collected from the Households Income and Expenditure Survey in 2016 and 2017. The final sample consisted of 54,354 households living in rural and urban regions of all the provinces. Inequalities in household's dental care expenditure per capita in respect to income quintiles and educational level were measured based on the Gini coefficient and concentration index.
The results showed that about 8% of households had paid for dental care during the month before sampling. The Gini coefficient value was estimated to be 0.97 and 0.96 for dental care expenditure per capita respectively in absolute and relative measure. It indicated a significant inequality in the dental expenditure among the sample households. The values of concentration index were positive and significant for all dental care subcategories in respect to the provincial and national income quintiles as well as the educational level of the head of the household.
Income and educational inequality in the both absolute and relative dental services expenditure of the Iranian households were in favor of higher income groups as well as higher educational level of household heads. Income inequality was higher in total dental care expenditure per capita and all its subcategories than the educational inequalities of dental expenditure. In order to reduce these inequalities, the policymakers need to pay special attention to low-income households, particularly those with low-educated heads.
口腔健康是影响人类生活的主要公共卫生问题之一。获得牙科保健是维护口腔健康的重要因素之一。本研究旨在调查伊朗家庭牙科保健支出的不平等情况。
本研究是对一项全国性横断面调查的二次分析。数据来自 2016 年和 2017 年的家庭收入和支出调查。最终样本包括来自所有省份城乡地区的 54354 户家庭。根据基尼系数和集中指数，衡量了家庭人均牙科保健支出在收入五分位数和教育水平方面的不平等。
结果表明，约有 8%的家庭在抽样前一个月支付了牙科保健费用。绝对和相对人均牙科保健支出的基尼系数值分别估计为 0.97 和 0.96，表明样本家庭的牙科支出存在显著不平等。集中指数的值在省级和全国收入五分位数以及家庭户主的教育水平方面均为正且显著，所有牙科保健亚类的集中指数均为正且显著。
伊朗家庭在绝对和相对牙科服务支出方面的收入和教育不平等都有利于高收入群体以及家庭户主的高教育水平。人均总牙科保健支出及其所有亚类的收入不平等程度高于牙科支出的教育不平等程度。为了减少这些不平等，政策制定者需要特别关注低收入家庭，特别是那些教育程度低的家庭。
