Inequalities in dental services use by older adults in Chile according to eligibility for a national dental programme

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2023-09-10 DOI:10.1111/cdoe.12909

Yanela Aravena-Rivas, Renato Venturelli, Michelle Stennett, Georgios Tsakos

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Abstract

Objectives

The objectives of this study were to determine the prevalence and trends in dental service use among Chilean older adults (60+ years) between 2006 and 2017; to assess the association between socioeconomic factors and dental service use and type (public/private) in 2017 and whether these differ by eligibility to a national dental programme (GES-60).

Methods

This study involved secondary data analysis of five nationally representative cross-sectional surveys between 2006 and 2017. Trends were assessed for use of dental services and types of services used among 60-79-year-olds. Logistic regression models examined the association between use of dental services in 2017 and socioeconomic variables (income and education), accounting for covariates (age, gender, residence, ethnicity, cohabiting status, employment and disability). Estimated marginal means and odds ratios (ORs) were calculated to assess the association between socioeconomic variables and the outcomes by GES-60 eligibility.

Results

Across surveys, the average prevalence of use of dental services in the last 3 months was 5.0%. There was a slight increase in dental visits between 2006 and 2017. This trend was higher among GES-60 eligible individuals using public dental services. Inequalities were observed in regression analyses. Compared to the poorest quintile and those with no formal education respectively, the ORs were 2.36 (95% confidence interval (CI) 1.79–5.68) for the richest quintile and ranged from 2.91 (95% CI 1.49–5.68) to 6.43 (3.26–12.68) for each higher level of educational attainment. Inequalities were wider among GES-60 non-eligible than GES-60 eligible older adults for both outcomes.

Conclusions

Socioeconomic inequalities were present among older adults regardless of GES-60 eligibility. However, these inequalities were more pronounced among non-eligible individuals. Our findings suggest a limited impact of GES-60 only among eligible older adults. Policies considering the needs of the whole older adult population are likely to have a stronger impact.

Abstract Image

查看原文本刊更多论文

智利老年人使用牙科服务的不平等，取决于是否有资格参加国家牙科计划。

研究目的本研究的目的是确定2006年至2017年间智利老年人（60岁以上）牙科服务使用的普遍程度和趋势；评估2017年社会经济因素与牙科服务使用和类型（公共/私人）之间的关联，以及这些因素是否因参加国家牙科计划（GES-60）的资格而有所不同：本研究对 2006 年至 2017 年期间的五项具有全国代表性的横断面调查进行了二次数据分析。评估了 60-79 岁人群使用牙科服务和服务类型的趋势。逻辑回归模型检验了 2017 年牙科服务使用情况与社会经济变量（收入和教育）之间的关联，并考虑了协变量（年龄、性别、居住地、种族、同居状况、就业和残疾）。通过计算估计的边际均值和几率比（ORs）来评估社会经济变量与 GES-60 资格结果之间的关联：在所有调查中，最近 3 个月使用牙科服务的平均比例为 5.0%。2006 年至 2017 年间，牙科就诊率略有上升。在使用公共牙科服务的符合 GES-60 标准的人群中，这一趋势更为明显。在回归分析中观察到了不平等现象。与最贫穷的五分之一人口和未受过正规教育的人口相比，最富有的五分之一人口的OR值为2.36（95%置信区间（CI）为1.79-5.68），教育程度每提高一个等级，OR值从2.91（95%置信区间（CI）为1.49-5.68）到6.43（3.26-12.68）不等。就这两项结果而言，不符合 GES-60 标准的老年人的不平等程度要高于符合 GES-60 标准的老年人：结论：无论是否符合 GES-60 标准，社会经济不平等在老年人中都存在。结论：无论 GES-60 是否符合条件，老年人中都存在社会经济不平等现象，但这些不平等现象在不符合条件的人群中更为明显。我们的研究结果表明，GES-60 只对符合条件的老年人产生了有限的影响。考虑全体老年人需求的政策可能会产生更大的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.

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