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接受公共援助的日本老年成年人看牙医的比例。

Prevalence of dental visits in older Japanese adults receiving public assistance.

机构信息

Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.

出版信息

Community Dent Oral Epidemiol. 2024 Feb;52(1):68-75. doi: 10.1111/cdoe.12902. Epub 2023 Aug 9.

Abstract

OBJECTIVES

Exemption from paying dental care costs among recipients of public assistance contributes to universal health care coverage. Although this system might reduce the financial barriers to dental care among patients, there are still several other barriers for public assistance recipients. Therefore, this study examined whether receiving public assistance was associated with a higher prevalence of dental visits for any reason, treatment and prevention.

METHODS

Data were obtained from 16 366 respondents from the 2019 wave of a nationwide cohort study on older adults in Japan. Poisson regression analyses with robust error variance were used to examine the associations between receiving public assistance and dental visits, adjusting for number of teeth, dental pain, periodontal conditions, age, sex, number of family members, education, equivalent household income, working status, instrumental activities of daily living, medical conditions, depressive symptoms, instrumental support and geographical variations.

RESULTS

More than half of the non-recipients of public assistance visited a dentist for some reason in the past 6 months. Meanwhile, only 37% of the recipients visited a dentist. In addition, almost half of the non-recipients had treatment visits, while only 34% of the recipients visited. Furthermore, 46% of the non-recipients had dental visits for prevention, while 32% of the recipients had preventive visits. In the fully adjusted models, compared to non-recipients, public assistance recipients were 24% (Prevalence Ratio [PR]: 0.76, 95% Confidence Intervals [CI]: 0.64, 0.90), 23% (PR: 0.77, 95% CI: 0.65, 0.92) and 21% (PR: 0.79, 95% CI: 0.65, 0.95) less likely to have dental visits for any reason, treatment, and prevention, respectively.

CONCLUSIONS

Although recipients were exempted from dental treatment fees, receiving public assistance was associated with a lower prevalence of dental visits for any reason, treatment and prevention. Future studies should identify the barriers to accessing dental care among public assistance recipients to improve dental visits.

摘要

目的

公共援助计划中的受助者无需支付牙科保健费用,这有助于实现全民健康覆盖。尽管该制度可能降低了患者获得牙科保健的经济障碍,但公共援助受助人仍面临其他一些障碍。因此,本研究旨在检验接受公共援助是否与更高的任何原因、治疗和预防的牙科就诊率相关。

方法

本研究数据来自日本一项针对老年人的全国队列研究在 2019 年的 16366 名受访者。采用具有稳健误差方差的泊松回归分析,调整牙齿数量、牙痛、牙周状况、年龄、性别、家庭成员数量、教育程度、家庭等效收入、工作状态、日常生活活动能力、医疗状况、抑郁症状、工具性支持和地理差异等因素后,检验接受公共援助与牙科就诊之间的关联。

结果

超过一半的非公共援助受助者在过去 6 个月内因某种原因看了牙医。而仅有 37%的受助者看了牙医。此外,近一半的非受助者接受了治疗性就诊,而仅有 34%的受助者接受了治疗性就诊。此外,46%的非受助者为预防目的而看牙,而 32%的受助者为预防目的而看牙。在完全调整后的模型中,与非受助者相比,公共援助受助者任何原因就诊的可能性分别低 24%(患病率比 [PR]:0.76,95%置信区间 [CI]:0.64,0.90)、23%(PR:0.77,95% CI:0.65,0.92)和 21%(PR:0.79,95% CI:0.65,0.95),分别用于任何原因、治疗和预防的就诊。

结论

尽管受助人免除了牙科治疗费用,但接受公共援助与任何原因、治疗和预防的牙科就诊率较低相关。未来的研究应确定公共援助受助人获得牙科保健的障碍,以提高牙科就诊率。

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