Dental care utilization of immigrants in Chengdu, China / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study considered Chengdu, Sichuan, China as an example to investigate the dental service utilization by foreigners and its influencing factors. Results of the study can be referred by dental practitioners to explore international development of dental services and can be provided for health policy makers to formulate oral health policies for immigrants.</p><p><b>METHODS</b>A simple random sampling method with a questionnaire was designed based on Anderson's health utilization model and "Oral Health Questionnaire for Adults" by the World Health Organization. Oral health condition, consciousness, and demographic data were collected. Binary Logistic regression and stratified analysis with SPSS 20.0 were performed.</p><p><b>RESULTS</b>A total of 654 immigrants repre-senting 75 countries participated in the study. Among all participants, 102 (15.6%) experienced dental problems while in residence in China but paid no visit to dentists. Female immigrants, who spent considerable time living in Chengdu, experienced oral problems in a year, used dental floss, and reported family members in Chengdu, were more likely to visit Chinese dentists. Participants who lived in Chengdu for at least 10.5 months were the threshold distinguishing differences in dental visits in the country.</p><p><b>CONCLUSIONS</b>The policymakers in Chengdu should consider creating a convenient and conducive dental care environment for immigrants. Additional information related to urgent oral and routine care should be provided to short- and long-term living immigrants in China. Dental practitioners in China should also contemplate on collaborating with foreign dental insurance companies to ensure better dental care access for immigrant patients.</p>

Dental care utilization by diabetics according to the Korea Health Panel Survey / 대한구강보건학회지

OBJECTIVES: The objective of this study was to examine the difference in dental care utilization between diabetics (diabetes group) and nondiabetics (normal group). METHODS: We examined the data of 5108 subjects enrolled in the Korea Health Panel Survey, every year for three years between 2010 and 2012. Of these, 458 subjects were included in the diabetes group and 458 in the normal group using the propensity score matching method to control confounding variables. To compare dental care utilization by the diabetes and normal groups, we examined the odds ratio (OR) and 95% confidence interval (CI) using a generalized estimating equation. RESULTS: We found that the odds of dental care utilization by the diabetes group compared with the normal group was significantly high (OR=1.82, 95% CI: 1.60-2.09). The result was consistent according to sensitivity analysis (OR=1.96, 95% CI: 1.63-2.35). CONCLUSIONS: Dental care utilization by the diabetes group was 82% higher than that by the normal group. Therefore, patients with diabetes need to be more concerned about oral health care.

Dental care utilization patterns by the status of ADL and IADL in the elderly / 대한구강보건학회지

OBJECTIVES: This study sought to analyze the effects of ADL and IADL on dental care utilization behaviors for the elderly 65 years of age and older. METHODS: Using data from the Korea Health Panel 2010-2011, we examined 2683 elderly people who did not use dental care and 12,550 cases of dental care utilization of 963 elderly people who used dental care among people aged 65 and older who responded to the items of ADL and IADL limitations. We employed two-part model (TPM) including logistic regression analysis in a first part of the model and negative binomial regression analysis in a second part of the model to estimate dental care utilization patterns associated with ADL and IADL of elderly adults. RESULTS: A frequency analysis revealed that dental care utilization was more frequent in the elderly with IADL limitations than in the elderly with ADL limitations. The first part of TPM predicted that dental care utilization was more likely to be present in males and younger age group along with increasing number of chronic diseases and independence in ADL and IADL. The results of the second part of TPM estimated the quantity of dental care utilization increased among high income groups. CONCLUSIONS: Limitations in ADL and IADL were found to affect the decision to seek dental care utilization, but physical limitations to have no statistical effect on the quantity of dental care utilization, once dental care utilization was taken for treatment. These findings suggested that dental care utilization would be determined by supplier induced demand and patient's own power to obtain treatment. Since decision to take dental care utilization, despite the barriers of limitations in activities, is an important factor which can satisfy medical needs, various policies to reflect oral health and physical fitness are required.

The effect of economic factors on private health insurance enrollment and dental care utilization / 대한구강보건학회지

OBJECTIVES: The study aimed to examine and derive policy implications from the contribution of private health insurance towards the effectiveness and equity of dental care utilization. METHODS: The study used 2010-2011 Korea Health Panel data. We applied a two-stage probit least square (2SPLS) analysis method to 10,577 people who were aged 20 years and over and had out-patient health care utilization. Under the assumption that high demanders for dental outpatient health services try to subscribe and hold private health insurance, the study focuses on the changes in income and private health insurance status. RESULTS: The results of the descriptive statistics indicated that the number of employed enrolled in private health insurance increased as age decreased and income increased. Two-year consecutive non-enrollment of private health insurance was highest in the groups aged 65 years or above, those that had completed primary school or below, and those that belonged to the top income bracket. The highest rates of continued enrollment in private health insurance were observed in the top fifth income group (highest quintile) and those with a college degree. Income was observed to have an effect on private health insurance enrollment status and the frequency of dental care services used. The results of the analysis indicated that changes in private health insurance status did not affect the frequency of dental care services used, but the frequency of dental care services used had a significantly positive effect on continued enrollment in private health insurance. CONCLUSIONS: To secure the right of health for citizens, it is necessary to establish measures that emphasize equity and strengthen benefit coverage of health insurance. Moreover, regulatory policies that support the low-income population are required.

Uso regular de serviços odontológicos entre adultos e idosos em região vulnerável no sul do Brasil / Regular use of dental services among adults and older adults in a vulnerable region in Southern Brazil / Uso regular de servicios odontológicos entre adultos y ancianos en región vulnerable en el sur de Brasil

OBJETIVO: Estimar a prevalência do uso regular de serviços odontológicos por adultos e idosos em comunidade vulnerável e identificar fatores associados. MÉTODOS: Estudo transversal de base populacional com 3.391 adultos e idosos de áreas de vulnerabilidade social de Porto Alegre, RS, de julho a dezembro de 2009. Foi utilizada amostragem sistemática com probabilidade proporcional ao tamanho de cada um dos 121 setores censitários. O desfecho "utilização regular de serviços odontológicos" foi definido consultar com o dentista regularmente, tendo ou não problemas de saúde bucal. Foi aplicado questionário padronizado, que incluiu variáveis demográficas, socioeconômicas, tipo de local procurado, autopercepção de saúde bucal e necessidades autopercebidas. Utilizou-se teste qui-quadrado para heterogeneidade na análise bivariada e na análise ajustada regressão de Poisson, com variância robusta e teste de heterogeneidade de Wald. RESULTADOS: A prevalência do uso regular de serviços odontológicos foi de 25,7%. A prevalência foi maior entre os indivíduos com escolaridade > 12 anos (RP 2,48 [IC95% 1,96;3,15]), mais ricos (RP: 1,95 [IC95% 1,03;1,53]), que utilizaram serviços privados de saúde (RP1,43 [IC95% 1,20;1,71]), com ótima autopercepção de saúde bucal (RP 4,44 [IC95% 3,07;6,42]) e autopercepção de necessidade de consultas para fins de revisão (RP 2,13 [IC95% 1,54;2,96]). CONCLUSÕES: Observam-se desigualdades na utilização regular de serviços odontológicos. Ações que contribuam para aumentar o conhecimento sobre a saúde bucal e melhoria do autocuidado, além de acesso a serviços odontológicos que visem à integralidade da atenção, podem contribuir para o aumento do uso regular dos serviços odontológicos.

OBJECTIVE: To estimate the prevalence of regular use of dental care services by adults and older adults residing in vulnerable community and to identify associated factors. METHODS: A population-based cross-sectional study was carried out with 3,391 adults and older adults residing in areas of social vulnerability in Porto Alegre, Southern Brazil, from July to December of 2009. A systematic sampling method was used the selection probability proportional to the population of each of the the 121 census sectors. The outcome for regular use of dental care services was defined as regular use of dental services, regardless of the presence of dental problems. A standardized questionnaire was administered, which included demographic, socioeconomic, type of dental care services, self-perception of dental health and self-perceived needs variables. A chi-square test for heterogeneity was used for bivariate analyses, and a Poisson regression with a robust variance and Wald tests were performed for the adjusted analysis. RESULTS: The prevalence of regular use of dental services was 25.7%. The prevalence was higher among people with >12 years schooling (PR 2.48 [95%CI:1.96;3.15]), higher income (PR 1.95[95%CI: 1.03;1.53]), use of private health services (PR 1.43 [95%CI: 1.20;1.71]),excellent self-perceived oral health (PR 4.44 [95%CI: 3.07;6.42]) and a self-perceived need for consultation related to routine checkup (RP 2.13 [95%CI: 1.54;2.96]). CONCLUSIONS: Inequalities were found in the regular use of dental services. Integrated approaches that raise awareness of oral health, improve self-care and expand access to dental services, may contribute to increase the use of dental services on a regular basis.

OBJETIVO: Estimar la prevalencia del uso regular de servicios odontológicos por adultos y ancianos en comunidad vulnerable e identificar factores asociados. MÉTODOS: Estudio transversal de base poblacional con 3.391 adultos y ancianos de áreas de vulnerabilidad social de Porto Alegre, Sur de Brasil, de julio a diciembre de 2009. Se utilizó muestreo sistemático con probabilidad proporcional al tamaño de cada uno de los 121 sectores censitarios. El resultado "utilización regular de servicios odontológicos" se definió como consulta con el dentista regularmente, teniendo o no problemas de salud bucal. Se aplicó cuestionario estandarizado que incluyó variables demográficas, socioeconómicas, tipo de lugar buscado, autopercepción de salud bucal y necesidades autopercibidas. Se utilizó la prueba de chi-cuadrado para heterogeneidad en el análisis bivariado y regresión de Poisson, en el análisis ajustado, con varianza robusta y prueba de heterogeneidad de Wald. RESULTADOS: La prevalencia del uso regular de servicios odontológicos fue de 25,7%. La prevalencia fue mayor entre los individuos con escolaridad > 12 años (RP 2,48 [IC95% 1,96;3,15]), más ricos (RP 1,95 [IC95% 1,03;1,53]), que utilizaron servicios privados de salud (RP 1,43 [IC95% 1,20;1,71]), con óptima autopercepción de salud bucal (RP 4,44 [IC95% 3,07;6,42]) y autopercepción de necesidad de consultas de revisión (RP 2,13 [IC95% 1,54;2,96]). CONCLUSIONES: Se observa desigualdades en la utilización regular de servicios odontológicos. Acciones que contribuyan para aumentar el conocimiento sobre la salud bucal y mejoría del autocuidado, así como de acceso a servicios odontológicos que busquen la integralidad de la atención, pueden favorecer el aumento del uso regular de los servicios odontológicos.