European Observatory on Health Systems and Policies and Department of Health Care Management, Berlin University of Technology.
Department of Oral Diagnostics, Digital Health and Health Services Research, Charité Universitätsmedizin.
Health Syst Transit. 2022 Jun;24(2):1-176.
With growing awareness of the large burden of oral diseases and how limited coverage affects both access and affordability, oral health policy has been receiving increased attention in recent years. This culminated in the adoption of the WHO resolution on Oral Health in 2021, which urges Member States to better integrate oral health into their universal health coverage and noncommunicable disease agendas. This study investigates major patterns and developments in oral health status, financing, coverage, access, and service provision of oral health care in 31 European countries. While most countries cover oral health care for vulnerable population groups, the level of statutory coverage varies widely across Europe resulting in different coverage and financing schemes for the adult population. On average, one third of dental care spending is borne by public sources and the remaining part is paid out-of-pocket or by voluntary health insurance. This has important ramifications for financial protection and access to care, leaving many dental problems untreated. Overall, unmet needs for dental care are higher than for other types of care and particularly affect low-income groups. Dental care is undergoing various structural changes. The number of dentists is increasing, and the composition of the health workforce is starting to change in many countries. Dental care is increasingly provided in group practices and by practices that are part of private equity firms. Although there are (early) signs of a shift towards more preventive therapies and policies of oral diseases, dental care overall remains focused on treatment. A lack of data affects all areas of oral health care. Current health information systems only collect very few indicators on oral health and oral health care. An improved evidence base would allow more meaningful assessments and comparisons of oral health systems performance. This in turn would allow better informed policy decisions and enable better targeted and more effective oral health interventions.
随着人们对口腔疾病负担的认识不断提高，以及覆盖面有限对可及性和可负担性的影响，口腔健康政策近年来受到越来越多的关注。这最终导致世卫组织在 2021 年通过了关于口腔健康的决议，敦促会员国更好地将口腔健康纳入全民健康覆盖和非传染性疾病议程。本研究调查了 31 个欧洲国家的口腔健康状况、融资、覆盖范围、可及性和口腔保健服务提供方面的主要模式和发展情况。虽然大多数国家为弱势群体的口腔保健提供保障，但欧洲各国的法定保障水平差异很大，导致成年人口的保障和融资计划也不同。平均而言，三分之一的牙科保健支出由公共资金承担，其余部分由自付费用或自愿健康保险支付。这对财务保障和获得保健服务产生了重要影响，导致许多牙科问题得不到治疗。总体而言，牙科保健的未满足需求高于其他类型的保健需求，特别是低收入群体受到的影响更大。牙科保健正在经历各种结构变化。牙医数量在增加，许多国家的卫生劳动力构成开始发生变化。牙科保健越来越多地由团体诊所和私营股本公司的一部分提供。尽管在向更多预防性治疗和口腔疾病政策转变方面有（早期）迹象，但整体而言，牙科保健仍侧重于治疗。缺乏数据影响口腔保健的所有领域。当前的卫生信息系统仅收集关于口腔健康和口腔保健的极少数指标。改善循证基础将允许对口腔卫生系统绩效进行更有意义的评估和比较。这反过来又将使政策决策更加明智，并使口腔卫生干预措施更有针对性和更有效。
