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收入增加如何影响低收入人群对牙科护理服务的使用:来自芬兰基本收入实验的证据。

How an increase in income affects the use of dental care services among a low-income population: evidence from the Finnish basic income experiment.

作者信息

Simanainen Miska

机构信息

Department of Sociology, Stockholm University, Universitetsvägen 10B, Floor 8 and 9, S-106 91, Stockholm, Sweden.

Social Insurance Institution of Finland, Helsinki, Finland.

出版信息

BMC Health Serv Res. 2024 Apr 22;24(1):499. doi: 10.1186/s12913-024-10933-0.

Abstract

BACKGROUND

Previous research has shown that the use of dental care services has a significant socioeconomic gradient. Lower income groups tend to use dental care services less, and they often have poorer dental health than higher income groups. The purpose of this study is to evaluate how an increase in income affects the use of dental care services among a low-income population.

METHODS

The study examines the causal effect of increasing cash transfers on the use of dental care services by utilizing unique register-based data from a randomized field experiment conducted in Finland in 2017-2018. The Finnish basic income experiment introduced an exogenous increase in the income of persons who previously received basic unemployment benefits. Register-based data on the study population's use of public and private dental care services were collected both for the treatment group (N = 2,000) and the control group (N = 173,222) of the experiment over a five-year period 2015-2019: two years before, two years during, and one year after the experiment. The experiment's average treatment effect on the use of dental care services was estimated with OLS regressions.

RESULTS

The Finnish basic income experiment had no detectable effect on the overall use of dental care services. However, it decreased the probability of visiting public dental care (-2.7% points, -4.7%, p =.017) and increased the average amount of out-of-pocket spending on private care (12.1 euros, 29.8%, p =.032). The results suggest that, even in a country with a universal public dental care coverage, changes in cash transfers do affect the dental care patterns of low-income populations.

摘要

背景

先前的研究表明,牙科护理服务的使用存在显著的社会经济梯度。低收入群体往往较少使用牙科护理服务,并且他们的牙齿健康状况通常比高收入群体更差。本研究的目的是评估收入增加如何影响低收入人群对牙科护理服务的使用。

方法

该研究利用2017 - 2018年在芬兰进行的一项随机实地实验中基于独特登记册的数据,考察增加现金转移对牙科护理服务使用的因果效应。芬兰基本收入实验使先前领取基本失业救济金的人的收入出现了外生增长。在2015 - 2019年的五年期间,收集了实验治疗组(N = 2000)和对照组(N = 173222)研究人群使用公共和私人牙科护理服务的基于登记册的数据:实验前两年、实验期间两年以及实验后一年。通过OLS回归估计了实验对牙科护理服务使用的平均治疗效果。

结果

芬兰基本收入实验对牙科护理服务的总体使用没有可检测到的影响。然而,它降低了去公共牙科护理就诊的概率(-2.7个百分点,-4.7%,p = 0.017),并增加了私人护理的自付费用平均金额(12.1欧元,29.8%,p = 0.032)。结果表明,即使在一个拥有全民公共牙科护理覆盖的国家,现金转移的变化确实会影响低收入人群的牙科护理模式。

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