The declining affordability of dental care in New Zealand from 1978 to 2023.

IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Ryan Gage, Jonathan Broadbent, William Leung, Martin Lee, Trudy Sullivan
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Abstract

Background: In the early 2020s, nearly half of New Zealand adults reported that cost of treatment had prevented them from accessing dental care, with higher rates among Māori, Pasifika and individuals living in the most deprived areas. Unaffordable dental care may be explained by a rise in dental service fees over time relative to personal income, as documented in New Zealand between 1978 and 1993. However, there have been no contemporary estimates in New Zealand of how the affordability of dental care has changed. The aims of this study were to analyse the change in dental treatment fees and the personal income of New Zealanders from 1978 to 2023 and to explore differences in affordability of dental care by ethnicity.

Methods: Average fees for dental treatments were sourced from surveys completed by practising New Zealand dentists. Earnings (from 1978) and personal income data (full population from 2000 and by ethnicity from 2008) were sourced from Statistics NZ and NZ Official Yearbooks. Inflation-adjusted changes in average fees, weekly personal earnings and income were calculated as a percentage change from 1978 levels for fees and earnings and from 2000 for personal income.

Results: For the five dental treatments with data available from 1978 to 2023, fees increased in the range of 75%-236%, while earnings increased by 46% over the same period. Fees for other treatments (with data available from 1981 to 2009) similarly increased and mostly surpassed changes in earnings. From 2008 to 2023 the overall increase in personal income (about 21% across all ethnic groups) kept pace with the rising cost of most treatments. However, due to persistent income inequalities, in 2023, Māori and Pasifika would need to spend a higher proportion of their weekly income (approximately 16% and 23% respectively) to receive the same dental treatments as NZ Europeans.

Conclusions: Fees for dental treatments have risen markedly in recent decades, more sharply than the price of other goods and services.

从 1978 年到 2023 年新西兰牙科保健费用的下降。
背景:2020 年代初,近一半的新西兰成年人表示,治疗费用使他们无法获得牙科护理,毛利人、太平洋岛民和生活在最贫困地区的人中这一比例更高。无法负担牙科保健费用的原因可能是牙科服务费用相对于个人收入而言随着时间的推移而增加,新西兰在1978年至1993年期间就有这方面的记录。然而,新西兰并没有对牙科保健的可负担性如何变化进行当代估算。本研究的目的是分析1978年至2023年期间新西兰人牙科治疗费用和个人收入的变化情况,并探讨不同种族在牙科保健负担能力方面的差异:牙科治疗的平均费用来自新西兰执业牙医完成的调查。收入(从1978年开始)和个人收入数据(从2000年开始的全人口数据和从2008年开始的不同种族数据)来自新西兰统计局和《新西兰官方年鉴》。经通货膨胀调整后的平均收费、每周个人收入和收入的变化是按与1978年收费和收入水平相比的百分比变化以及与2000年个人收入相比的百分比变化计算的:结果:对于从 1978 年到 2023 年有数据可查的五种牙科治疗,费用增长幅度在 75%-236% 之间,而同期收入增长了 46%。其他治疗费用(1981 年至 2009 年的数据)也有类似增长,且大部分超过了收入的变化。从 2008 年到 2023 年,个人收入的总体增长(在所有种族群体中约为 21%)与大多数治疗费用的增长保持同步。然而,由于持续存在的收入不平等,到2023年,毛利人和太平洋岛民将需要花费更高比例的周收入(分别约为16%和23%),才能接受与新西兰欧洲人相同的牙科治疗:近几十年来,牙科治疗费用明显上涨,涨幅超过了其他商品和服务的价格。
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来源期刊
Community dentistry and oral epidemiology
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
82
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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