Public Dental Expenditure and Dental Visits in Europe and Japan

IF 2.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2026-10-15 Epub Date: 2026-05-31 DOI:10.1111/cdoe.70076

Yuko Inoue, Jun Aida, Richard G. Watt, Anja Heilmann

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引用次数: 0

Abstract

Background

Dental care is important for oral health, but access to dental services is subject to social inequalities and varies between countries. Despite this, few cross-national studies have examined how public dental expenditure relates to dental service use among older adults. This study aimed to investigate the associations between public dental expenditure and dental visits among older adults using an international comparative design.

Methods

Data were obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE, Wave 8, 2019), covering 25 European countries and Israel, and the Japanese Gerontological Evaluation Study (JAGES, 2019). The final sample included 48 497 adults aged 65 years or older. The outcome was any dental visit in the past year, while the explanatory variable was country-level annual per capita public dental expenditure on outpatient dental care in 2019 (USD), obtained from the OECD database and adjusted for purchasing power parity. A multilevel modified Poisson regression model was used to estimate prevalence ratios (PRs), accounting for between-country variability. Interaction terms between household income and public dental expenditure were included to examine effect modification.

Results

The overall dental visit rate was 59.5%, with higher rates among women, those with higher education, and those in higher income groups. Each $10 increase in per capita public dental expenditure at the country level was associated with higher dental visit rates (PR: 1.05, 95% CI: 1.03–1.07). The association was stronger among lower-income groups, suggesting that income-related inequalities in dental visits were smaller in countries with higher public dental expenditure.

Conclusions

Public expenditure on dental care was associated with higher dental visit rates, particularly among low-income groups. These findings suggest that public financing of dental care may help reduce income-related inequalities in dental visits among older adults.

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欧洲及日本的公共牙科开支及牙科就诊情况。

背景：牙科保健对口腔健康很重要，但获得牙科服务受到社会不平等的影响，各国之间也有所不同。尽管如此，很少有跨国研究调查公共牙科支出与老年人牙科服务使用之间的关系。本研究旨在利用国际比较设计调查老年人公共牙科费用与牙科就诊之间的关系。方法：数据来自欧洲健康、老龄化和退休调查（SHARE, Wave 8, 2019），涵盖25个欧洲国家和以色列，以及日本老年学评估研究（JAGES, 2019）。最终的样本包括48497名65岁或以上的成年人。结果是过去一年的任何牙科就诊，而解释变量是2019年国家一级门诊牙科护理的人均公共牙科支出（美元），该数据来自经合组织数据库，并根据购买力平价进行了调整。使用多水平修正泊松回归模型来估计患病率（pr），考虑到国家之间的差异。加入家庭收入与公共牙科支出之间的交互项，以检验效应的修正。结果：整体访牙率为59.5%，女性、高学历、高收入人群访牙率较高。在国家一级，人均公共牙科支出每增加10美元与更高的牙科就诊率相关（PR: 1.05, 95% CI: 1.03-1.07）。这种关联在低收入群体中更强，这表明在公共牙科支出较高的国家，与收入相关的牙科就诊不平等较小。结论：牙科保健的公共支出与较高的牙科就诊率有关，特别是在低收入群体中。这些发现表明，牙科保健的公共资金可能有助于减少老年人牙科就诊中与收入相关的不平等。

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.