Assessment of demand for and utilization of dental services by insurance coverage in a developing oral health care system
Journal of Dental School, Shahid Beheshti University of Medical Sciences,
Vol. 35 No. 2 (2017),
6 March 2019
,
Page 36-42
https://doi.org/10.22037/jds.v35i2.24612
Abstract
Objectives This study aimed to evaluate the relationship between demand for and utilization of dental services by insurance coverage among adults in Iran.
Methods A cross-sectional survey based on telephone interviews was done. A total of 6,029 adults participated in this study conducted in Iran. The interviews were carried out using a structured questionnaire and covered dental visits, demographics and socio-economic background.
Results Of 6,029 participants, 86% reported having health insurance, 58% had public, and 28% had both public and commercial insurance. Those with both public and commercial insurance coverage had higher odds for dental visits within the past 12 months [odds ratio (OR) = 1.5], and for dental check-ups (OR = 1.5). Receipt of restorative and expensive services (OR = 1.4) was more likely by those with both public and commercial insurance. Tooth extraction was more likely in subjects with no insurance coverage (OR = 1.6).
Conclusion This study revealed a positive relationship between insurance coverage and demand for and utilization of dental services in a country with a developing health care system.
- composite resins
- tooth discoloration
- aging
How to Cite
References
Grytten J, Holst D. Perspectives on providing good access to dental services for elderly people: patient selection, dentists’ responsibility and budget management. Gerodontology. 2013;30:98–104.
Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in canada. J Can Dent Assoc. 2007;73:57.
Anikeeva O, Brennan DS, Teusner DN. Household income modifies the association of insurance and dental visiting. BMC Health Serv Res. 2013;13:432.
Teusner DN, Brennan DS, Spencer AJ. Dental insurance, attitudes to dental care, and dental visiting. J Public Health Dent. 2013;73:103–111.
Thompson B, Cooney P, Lawrence H, Ravaghi V, Quiñonez C. Cost as a barrier to accessing dental care: findings from a canadian population based study. J Public Health Dent. 2014;74:210–218.
Grembowski D, Conrad D, Weaver M, Milgrom P. The structure and function of dental-care markets: a review and agenda for research. Med Care. 1988;26:132–147.
Grytten J, Holst D, Skau I. Demand for and utilization of dental services according to household income in the adult population in norway. Community Dent Oral Epidemiol. 2012;40:297–305.
So FHC, Schwarz E. Demand for and utilization of dental services among Hong kong employees with and without dental benefit coverage. Community Dent Oral Epidemio. 1996;24:201–206.
Handel BR. Adverse selection and inertia in health insurance markets: when nudging hurts. Am Econ Rev. 2013;103:2643–2682.
Manski RJ. Dental insurance: design, need, and public policy. J Am Coll Dent. 2001;68:9–13.
Yuan C, Zhu L, Li Y, Liu M, Si Y, Zhang F. Oral health services utilization and influencing factors in downtown community residents older than 15 years in beijing. Zhonghua Kou Qiang Yi Xue Za Zhi. 2011;46:182–185.
Christian B, Chattopadhyay A, Kingman A, Boroumand S, Adams A, Garcia I. Oral health care services utilisation in the adult us population: Medical expenditure panel survey 2006. Community Dent Health. 2013;30:161–167.
Feldstein PJ. Financing dental care: an economic analysis. Financing dental care: an economic analysis. 1973.
Nguyen L. Dental service utilization, dental health production and equity in dental care: the finnish experience. 2008.
Brennan DS, Luzzi L, Roberts-Thomson KF. Dental service patterns among private and public adult patients in Australia. BMC Health Serv Res. 2008;8:1.
Sweet M, Damiano P, Rivera E, Kuthy R, Heller K. A comparison of dental services received by medicaid and privately insured adult populations. J Am Dent Assoc. 2005;136:93–100.
Samadzadeh. Ministry of health and medical education OHD. Oral Health report. 2012:4–120.
Iran. MCo. List of dentists. Medical Council of Iran. 2013.
Yearbook IS. Statistical center of Iran. Tehran, Iran. 2013.
Bayat F, Vehkalahti MM, Tala H, Zafarmand AH. Dental attendance by insurance status among adults in Tehran, Iran. Int Dent J. 2006;56:338–344.
Ghorbani Z, Ahmady AE, Ghasemi E, Zwi A. Socioeconomic inequalities in oral health among adults in Tehran, Iran. Community Dent Health. 2015;32:26–31.
Suominen-Taipale AL. Demand for oral health care services in adult finns: Turun Yliopisto; 2000.
Bayat F, Murtomaa H, Vehkalahti MM, Tala H. Does dental insurance make a difference in type of service received by Iranian dentate adults? Eur J Dent. 2011;5:68–76.
Bayat F, Vehkalahti MM, Murtomaa H, Tala H. Why do adults entitled to free or highly subsidized dental services select fully out of pocket paid care? Community Dent Oral Epidemiol. 2010;38:88–95.
Ghorbani Z, Ahmady AE, Lando HA, Yazdani S, Amiri Z. Development of a socioeconomic status index to interpret inequalities in oral health in developing countries. Oral Health Prev Dent. 2013;11:9–15.
Amini N. Iranian provenances ranking according to access to health sector indicators. Social Welfare Quarterly. 2006;5:27–48.
Sohn W, Ismail AI. Regular dental visits and dental anxiety in an adult dentate population. J Am Dent Assoc. 2005;136:58–66.
Chapin R. Dental benefits improve access to oral care. Dent Clin North Am. 2009;53:505–509.
Manning WG, Bailit HL, Benjamin B, Newhouse JP. The demand for dental care: evidence from a randomized trial in health insurance. J Am Dent Assoc. 1985;110:895–902.
Riley P, Worthington HV, Clarkson JE, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev. 2013;CD004346.
Schouten B, Mettes T, Weeda W, Hoogstraten J. Dental check-up frequency: preferences of dutch patients. Community Dent Health. 2006;23:133–139.
Sivaneswaran S. The oral health of adults in NSW, 2004–06. NSW Public Health Bull. 2009;20:46–51.
Petersen PE, Peng B, Tai B, Bian Z, Fan M. Effect of a school based oral health education programme in Wuhan city, peoples republic of China. I Int Dent J. 2004;54:33–41.
Birch S, Anderson R. Financing and delivering oral health care: what can we learn from other countries. J Can Dent Assoc. 2005;71:243, 243a–243d.
Yazdani R, Vehkalahti M, Nouri M, Murtomaa H. Oral health and treatment needs among 15-year-olds in Tehran, Iran. Community Dent Health. 2008;25:221–225.
Meyerhoefer CD, Zuvekas SH, Manski R. The demand for preventive and restorative dental services. Health Econ. 2014;23:14–32.
Brennan DS, Spencer AJ. Practice profiles of Australian private general dental practitioners. Aust Dent J. 2006;51:91–93.
Pam Silberman J, Odom CH, MRP TL, Holmes GM. North Carolina’s uninsured. N C Med J. 2006;67:183–191.
Schwarz E. Changes in utilization and cost sharing within the Danish national health insurance dental program, 1975–90. Acta Odontol Scand. 1996;54: 29–35.
Brennan D, Spencer A. The role of dentist, practice and patient factors in the provision of dental services. Community Dent Oral Epidemiol. 2005;33: 181–195.
Hessari H, Vehkalahti MM, Eghbal MJ, Samadzadeh H, Murtomaa HT. Oral health and treatment needs among 18-year-old Iranians. Med Princ Pract. 2008;17:302–307.
Saied-Moallemi Z, Virtanen J, Tehranchi A, Murtomaa H. Disparities in oral health of children in Tehran, Iran. Eur Arch Paediatr Dent. 2006;7:262–264.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–669.
Ghasemi H, Murtomaa H, Torabzadeh H, Vehkalahti MM. Knowledge of and attitudes towards preventive dental care among Iranian dentists. Eur J Dent. 2007;1:222–229.
Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the united states. Milbank Q. 2005;83:Online-only.
Grytten J, Lund E, Rongen G. Equity in access to public dental services: the experience from Norway. Acta Odontol Scand. 2001;59:372–378.
Guilbert JJ. The world health report 2006: working together for health. Educ Health (Abingdon). 2006;19:385–387.
Widström E, Eaton K, Vanobbergen J. Oral healthcare systems in the extended European union, Partim: [oral health care system in] Belgium. Oral Health Prev Dent. 2004;2:155–157.
Mofidi M. Dentist participation in medicaid: key to assuring access for North Carolina’s most underserved. NC Med J. 2005;66:456–459.
- Abstract Viewed: 152 times
- PDF Downloaded: 157 times