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评估牙科保险在加拿大成年人口腔保健差异中的作用。

Assessing the role of dental insurance in oral health care disparities in Canadian adults.

机构信息

Centre for Direct Health Measures, Statistics Canada.

Faculty of Dentistry, University of Toronto.

出版信息

Health Rep. 2024 Apr 17;35(4):3-14. doi: 10.25318/82-003-x202400400001-eng.

Abstract

BACKGROUND

This study examines the association of dental insurance with oral health care access and utilization in Canada while accounting for income and sociodemographic factors. It contributes to a baseline of oral health care disparities before the implementation of the Canadian Dental Care Plan (CDCP).

DATA AND METHODS

This retrospective study of Canadians aged 18 to 64 years is based on data from the 2022 Canadian Community Health Survey. Multivariable logistic regression was employed to evaluate the association of dental insurance with the recency and frequency of dental visits, as well as avoidance of dental care because of cost.

RESULTS

Overall, 65.7% of Canadians reported visiting a dental professional in the previous year: 74.6% of those with private insurance, 62.8% with public insurance, and 49.8% uninsured. Cost-related avoidance of dental care was 16.0%, 20.9%, and 47.4% for the privately insured, publicly insured, and uninsured, respectively. After adjustment, adults with private (odds ratio [OR]=2.54; 95% confidence interval [CI]: 2.32 to 2.78) and public (OR=2.17; 95% CI: 1.75 to 2.68) insurance were more likely to have visited a dental professional in the last year compared with those without insurance. Similarly, both private (OR=0.22; 95% CI: 0.20 to 0.25) and public (OR=0.22; 95% CI: 0.17 to 0.29) insurance holders showed a significantly lower likelihood of avoiding dental visits because of cost when compared with uninsured individuals.

INTERPRETATION

This study showed the significant association of dental insurance with access to oral health care in Canada, contributing to setting a critical benchmark for assessments of the CDCP's effectiveness in addressing oral health disparities.

摘要

背景

本研究考察了在考虑收入和社会人口因素的情况下,加拿大的牙科保险与口腔保健服务的可及性和利用率之间的关系。这为在实施加拿大牙科保健计划(CDCP)之前的口腔保健服务差距提供了一个基线。

数据和方法

这项针对 18 至 64 岁加拿大人的回顾性研究基于 2022 年加拿大社区健康调查的数据。采用多变量逻辑回归评估了牙科保险与最近一次和定期看牙医以及因费用而避免看牙医的相关性。

结果

总体而言,65.7%的加拿大人报告在过去一年中看过牙科专业人士:私人保险者为 74.6%,公共保险者为 62.8%,无保险者为 49.8%。因费用而避免看牙医的比例分别为私人保险者的 16.0%、公共保险者的 20.9%和无保险者的 47.4%。调整后,与没有保险的成年人相比,拥有私人保险(比值比 [OR]=2.54;95%置信区间 [CI]:2.32 至 2.78)和公共保险(OR=2.17;95% CI:1.75 至 2.68)的成年人更有可能在过去一年中看过牙科专业人士。同样,私人保险(OR=0.22;95% CI:0.20 至 0.25)和公共保险(OR=0.22;95% CI:0.17 至 0.29)的持有者与没有保险的人相比,因费用而避免看牙医的可能性显著降低。

解释

本研究表明,加拿大的牙科保险与口腔保健服务的可及性之间存在显著关联,为评估 CDCP 在解决口腔健康差距方面的有效性提供了一个重要的基准。

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