Department of Dental Hygiene, Shinhan University, 95, Hoam-ro, Uijeongbu-si 11644, Korea.
Department of Dental Hygiene, Namseoul University, 91, Cheonan-si 31020, Korea.
Int J Environ Res Public Health. 2022 Feb 12;19(4):2051. doi: 10.3390/ijerph19042051.
This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health Panel from 2008 to 2017 and analyzed each dental service episode. Since the distribution of travel time was skewed to the left, median travel time was analyzed. The association of travel time with services was analyzed via the population-averaged generalized estimating equation (GEE) with the Poisson family. The median of the average travel time per episode was longer for non-National Health Insurance (NHI)-covered services and shorter for NHI-covered services. The first quintile of low-income subjects traveled the longest for all services and utilized dental care the most. In the GEE analysis, travel time was approximately three times longer for implant treatment and gold inlay/resin fillings and >2 times longer for orthodontic care than for NHI-covered services. Patients residing in rural counties traveled for longer than residents of large cities. Income was statistically significant; however, the coefficient was close to zero. Travel time was related to the type of service and reflected patient preference. This was more prominent for expensive non-NHI-covered services than for NHI-covered services. The findings suggest patients' subjective preferences for dental clinic selection are expressed as rational deliberation considering each individual's situation.
本研究分析了患者在选择牙科保健服务时，基于居住地到牙科机构的出行时间选择偏好。我们使用了 2008 年至 2017 年的韩国健康面板数据，并对每个牙科服务案例进行了分析。由于出行时间的分布向左偏斜，我们分析了中位数出行时间。使用泊松家族的人群平均广义估计方程（GEE）分析出行时间与服务之间的关联。非全民健康保险（NHI）覆盖服务的平均每次出行时间中位数较长，而 NHI 覆盖服务的平均每次出行时间中位数较短。所有服务中，低收入人群的第一五分位数出行时间最长，使用牙科保健服务的频率最高。在 GEE 分析中，与 NHI 覆盖服务相比，种植牙治疗和金嵌体/树脂填充的出行时间约长三倍，正畸治疗的出行时间长两倍以上。居住在农村县的患者出行时间比居住在大城市的患者长。收入具有统计学意义；然而，系数接近零。出行时间与服务类型有关，反映了患者的偏好。对于昂贵的非 NHI 覆盖服务而言，这种关系比 NHI 覆盖服务更为显著。研究结果表明，患者对牙科诊所选择的主观偏好表现为在考虑到每个人的具体情况的基础上进行理性的权衡。
