Dental Public Health Department, Faculty of Dentistry, Paris University, 75006 Paris, France.
Inserm U1018, Centre de Recherche en Épidémiologie et Santé des Populations, 94807 Villejuif, France.
Int J Environ Res Public Health. 2022 Jan 25;19(3):1310. doi: 10.3390/ijerph19031310.
(1) Background: This study investigated how individual enabling resources influence (i) their probability of using dental services and (ii) consumers' expenditure on dental treatment. (2) Methods: Data were derived from a self-administered national health survey questionnaire and from expenditure data from national health insurance. Multiple linear regression methods were used to analyze entry into the dental health system (yes/no) and, independently, the individual expenditure of dental care users. (3) Results: People with the highest incomes were more likely to use dental service (aOR = 1.59; 95% CI = 1.28, 1.97), as were those with complementary health insurance and the lowest deprivation scores. For people using dental services, good dental health status was associated with less expenditure (-70.81 EUR; 95% CI = -116.53, -25.08). For dental service users, the highest deprivation score was associated with EUR +43.61 dental expenditure (95% CI = -0.15; 87.39). (4) Conclusion: Socioeconomic determinants that were especially important for entry into the dental health service system were relatively insignificant for ongoing service utilization. These results are consistent with our hypothesis of a dental care utilization process in two steps. Public policies in countries with private fees for dentistry should improve the clarity of dental fees and insurance payments.
(1) 背景:本研究旨在探讨个体赋权资源如何影响(i)他们使用牙科服务的概率,以及(ii)消费者在牙科治疗上的支出。(2) 方法:数据来自一项自我管理的全国健康调查问卷和国家健康保险支出数据。采用多元线性回归方法分析进入牙科保健系统(是/否)的情况,并分别分析牙科保健使用者的个人支出情况。(3) 结果:收入最高的人更有可能使用牙科服务(aOR = 1.59;95%CI = 1.28,1.97),而拥有补充健康保险和最低剥夺评分的人也是如此。对于使用牙科服务的人来说,良好的牙齿健康状况与较低的支出相关(-70.81 欧元;95%CI = -116.53,-25.08)。对于使用牙科服务的人来说,最高的剥夺评分与 43.61 欧元的牙科支出相关(95%CI = -0.15;87.39)。(4) 结论:对于进入牙科保健服务系统特别重要的社会经济决定因素,对于持续的服务利用相对不重要。这些结果与我们关于两步式牙科保健利用过程的假设一致。在有私人牙科费用的国家,公共政策应提高牙科费用和保险支付的透明度。