Lim Ji-Yeon, Lee Ju-Mi, Nam Hae-Sung
Department of Public Health, Graduate School, Chungnam National University, Daejeon, Republic of Korea.
Department of Preventive Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Gerodontology. 2025 May 3. doi: 10.1111/ger.12823.
To provide policy-relevant evidence to reduce oral health disparities and improve dental care accessibility by considering characteristics of urban and rural areas.
Individual and regional factors influence dental care access. Regional poverty and limited dental resources among older adults may contribute to unmet dental care needs due to cost.
A multilevel logistic regression analysis was conducted to examine the association between regional factors (regional deprivation, number of dentists per 10,000 and number of dental offices per 100,000) and unmet dental care needs due to cost. The analysis was adjusted for individual factors, such as sex, education, marital status, household income, subjective health status, chewing difficulty and limited daily activities, as determined by the 2021 Korean Community Health Survey (KCHS; n = 47,802).
The prevalence of unmet dental care needs due to cost was 4.94% in urban and 4.80% in rural older adults. Individuals who lived in higher regional deprivation (poorer regions) were less likely to experience unmet dental care needs due to cost (OR = 0.66, 95% CI = 0.47-0.94) only in rural areas. Individuals residing in areas with a higher number of dentists per 10,000 were more likely to experience unmet dental care needs due to cost in urban (OR = 2.19, 95% CI = 1.01-4.73) and rural (OR = 1.97; 95% CI = 1.16-3.34). Household income and oral health status were the strongest predictors of unmet dental care needs due to cost.
The influence of regional poverty, dentist distribution and individual factors should be considered in developing policies to reduce the unmet dental care needs of older Koreans.
通过考虑城乡地区的特点，提供与政策相关的证据，以减少口腔健康差距并提高牙科护理的可及性。
个体和地区因素会影响牙科护理的可及性。老年人中的地区贫困和有限的牙科资源可能由于成本原因导致未满足的牙科护理需求。
进行了多层次逻辑回归分析，以检验地区因素（地区贫困程度、每万人牙医数量和每十万人口牙科诊所数量）与因成本导致的未满足牙科护理需求之间的关联。该分析针对个体因素进行了调整，如性别、教育程度、婚姻状况、家庭收入、主观健康状况、咀嚼困难和日常活动受限等，这些数据来自2021年韩国社区健康调查（KCHS；n = 47,802）。
城市老年人中因成本导致的未满足牙科护理需求患病率为4.94%，农村为4.80%。仅在农村地区，生活在地区贫困程度较高（较贫困地区）的个体因成本导致未满足牙科护理需求的可能性较小（OR = 0.66，95% CI = 0.47 - 0.94）。每万人牙医数量较多地区的居民在城市（OR = 2.19，95% CI = 1.01 - 4.73）和农村（OR = 1.97；95% CI = 1.16 - 3.34）因成本导致未满足牙科护理需求的可能性更大。家庭收入和口腔健康状况是因成本导致未满足牙科护理需求的最强预测因素。
在制定减少韩国老年人未满足牙科护理需求的政策时，应考虑地区贫困、牙医分布和个体因素的影响。
