Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore

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

Community dentistry and oral epidemiology Pub Date : 2024-04-21 DOI:10.1111/cdoe.12962

Sharon Hui Xuan Tan, Gabriel Keng Yan Lee, Charlene Enhui Goh, Huei Jinn Tong, Janice Cheah Ping Chuang, Kok-Yang Ang, David Guang Xu Lim, Xiaoli Gao

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Abstract

Background/Aim(s)

Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore.

Methods

Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD.

Results

Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08–1.52), 1.48 (95% CI 1.14–1.92) and 1.36 (95% CI 1.09–1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies.

Conclusion

Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.

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收入和财政补贴对新加坡残疾人口腔保健使用情况的影响。

背景/目的在全球范围内，研究表明智力和/或发育障碍（IDD）患者的牙科疾病负担很重，这可能是由于牙科服务的利用率较低所致。本研究旨在评估收入和财政补贴对新加坡智障人士使用牙科保健服务的影响。方法在2020年8月至2021年8月期间，通过新加坡为智障人士提供婴幼儿早期干预计划的中心、特殊教育学校和成人协会开展了一项横断面研究。共有 591 名智障儿童和成人的照顾者完成了调查。调查收集了有关社会人口学信息、口腔健康行为和牙科使用情况的数据。财政补贴状况是通过低收入家庭是否参加政府资助、可选择参加的 "社区卫生援助计划"（CHAS）来评估的。统计分析采用单变量、多元逻辑回归和修正泊松回归法进行。在 R 4.0.2 版本中进行了倾向得分匹配，以评估财政补贴对 IDD 患者口腔保健利用率的影响。结果与家庭月总收入较低的人群相比，家庭月总收入在4000新元以上的智障人士在过去一年至少看一次牙医、过去一年至少看一次预防性牙医和每年至少看一次牙医的调整流行率分别为1.28（95% CI 1.08-1.52）、1.48（95% CI 1.14-1.92）和1.36（95% CI 1.09-1.70）。在合資格領取醫療輔助隊藍卡津貼的 247 名參加者中，有 160 人 (62.0%) 參加了醫療輔助隊藍卡計劃，96 人 (35.4%) 至少每年看一次牙醫。结论家庭收入越高，过去一年看牙医、过去一年预防性看牙医以及至少每年看牙医的比例越高。CHAS Blue补贴本身对符合补贴条件的IDD患者的牙科使用率影响有限。

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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.