Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Faculty of Dentistry, Clinical Center, University of Debrecen, Debrecen, Hungary.
PLoS One. 2023 Jun 9;18(6):e0286192. doi: 10.1371/journal.pone.0286192. eCollection 2023.
The use of dental care among older people is low compared to other forms of health care, with significant health consequences. However, the evidence on the extent to which countries' welfare systems and socio-economic factors influence the uptake of dental care by older people is limited. This study aimed to describe trends of dental care utilisation, and to compare use of dental care with other types of healthcare services among the elderly, considering different socio-economic factors and welfare systems in European countries.
Multilevel logistic regression analysis was performed using longitudinal data from four waves (between Wave 5 and 8) of the Survey of Health, Ageing and Retirement in Europe database, with a follow-up period of 7 years. The study sample included 20,803 respondents aged 50 years or older from 14 European countries.
The annual dental care attendance was the highest in Scandinavian countries (85.7%), however, improving trends of dental attendance was recognized in Southern and Bismarckian countries (p<0.001). The difference in use of dental care services between socio-economic groups was expanding over time regarding low- and high-income level and residential area. A more marked difference was observed between social groups in dental care utilisation compared to other forms of care. Income level and unemployed status had significant effect on forgoing dental care due to cost and unavailability.
The observed differences between socioeconomic groups may highlight the health consequences of the different organization and financing of dental care. The elderly population could benefit from adopting policies aiming to reduce the financial barriers to dental care usage, especially in Southern and Eastern European countries.
与其他形式的医疗保健相比，老年人对牙科保健的利用率较低，这会带来严重的健康后果。然而，关于各国福利制度和社会经济因素对老年人接受牙科保健的影响程度的证据有限。本研究旨在描述牙科保健利用率的趋势，并考虑到欧洲国家不同的社会经济因素和福利制度，比较老年人对牙科保健和其他类型医疗保健服务的利用情况。
使用欧洲健康、老龄化和退休调查数据库的四个波次（第 5 波至第 8 波之间）的纵向数据，采用多水平逻辑回归分析方法，随访时间为 7 年。研究样本包括来自 14 个欧洲国家的 20803 名 50 岁及以上的受访者。
在斯堪的纳维亚国家，每年的牙科就诊率最高（85.7%），但南欧和俾斯麦式国家的牙科就诊率呈上升趋势（p<0.001）。随着时间的推移，在低和高收入水平以及居住地区，社会经济群体之间在牙科保健服务利用方面的差异不断扩大。与其他形式的护理相比，在牙科保健利用方面，社会群体之间的差异更为明显。收入水平和失业状况对因费用和不可用而放弃牙科保健有显著影响。
观察到的社会经济群体之间的差异可能突出了牙科保健不同组织和融资方式对健康的影响。老年人口可能受益于采取旨在减少牙科保健使用的经济障碍的政策，特别是在南欧和东欧国家。
