Dental service utilization in the very old: an insurance database analysis from northeast Germany

Abstract Objectives We assessed dental service utilization in very old Germans. Methods A comprehensive sample of 404,610 very old (≥ 75 years), insured at a large statutory insurer (Allgemeine Ortskrankenkasse Nordost, active in the federal states Berlin, Brandenburg, Mecklenburg-Western Pomerania), was followed over 6 years (2012–2017). Our outcome was the utilization of dental services, in total (any utilization) and in five subgroups: (1) examinations and associated assessment or advice, (2) restorations, (3) surgery, (4) prevention, (5) outreach care. Association of utilization with (1) sex, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses, and (6) German modified diagnosis-related groups (GM-DRGs) was explored. Results The mean (SD) age of the sample was 81.9 (5.4) years. The utilization of any dental service was 73%; utilization was highest for examinations (68%), followed by prevention (44%), surgery (33%), restorations (32%), and outreach care (13%). Utilization decreased with age for nearly all services except outreach care. Service utilization was significantly higher in Berlin and most cities compared with rural municipalities, and in individuals with common, less severe, and short-term conditions compared with life-threatening and long-term conditions. In multi-variable analysis, social hardship status (OR: 1.14; 95% CI: 1.12-1.16), federal state (Brandenburg 0.85; 0.84–0.87; Mecklenburg-Western Pomerania: 0.80; 0.78–0.82), and age significantly affected utilization (0.95; 0.95–0.95/year), together with a range of co-morbidities according to ICD-10 and DRG. Conclusions Social, demographic, regional, and general health aspects were associated with the utilization of dental services in very old Germans. Policies to maintain access to services up to high age are needed. Clinical significance The utilization of dental services in the very old in northeast Germany showed significant disparities within populations. Policies to allow service utilization for sick, economically disadvantaged, rural and very old populations are required. These may include incentives for outreach servicing, treatment-fee increases for specific populations, or referral schemes between general medical practitioners and dentists.

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Prosthetic treatment patterns in the very old: an insurance database analysis from Northeast Germany

Clinical Oral Investigations ◽

10.1007/s00784-020-03264-x ◽

2020 ◽

Vol 24 (11) ◽

pp. 3981-3995 ◽

Cited By ~ 2

Author(s):

Fabian M. Hempel ◽

Joachim Krois ◽

Sebastian Paris ◽

Florian Beuer ◽

Adelheid Kuhlmey ◽

...

Keyword(s):

Multivariable Analysis ◽

Federal State ◽

Very Old ◽

Services Utilization ◽

Federal States ◽

Icd 10 ◽

Life Threatening ◽

Fixed Dental Prostheses ◽

The Mean ◽

High Age

Abstract Objectives We assessed dental prosthetic services utilization in very old Germans. Methods A comprehensive sample of 404,610 very old (≥ 75 years), insured at one large statutory insurer (Allgemeine Ortskrankenkasse Nordost, acting in the federal states Berlin, Brandenburg, Mecklenburg-Vorpommern), were followed over 6 years (2012–2017). Our outcome was the utilization of prosthetic services, in total and seven subgroups: (1) Crowns/partial crowns, (2) fixed dental prostheses (FDPs), (3) partial removable prostheses (RDPs), (4) full RDPs, (5) temporary services, (6) relining/rebasing/repairing/extending RDPs, (7) repairing FDPs. Association of utilization with (1) gender, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses and (6) German diagnoses related groups (G-DRG) was explored. Results The mean (SD) age of the sample was 81.9 (5.4) years; mean follow-up was 1689 (705) days. The mean utilization of any prosthetic service was 27.0%; the most often utilized service type were total RDPs (13.2% utilization), crowns (8.1%), and partial RDPs (7.1%). Utilization decreased with age for nearly all services (except relining/rebasing/repairing/extending RDPs) Utilization of prosthetic services was significantly higher in Berlin and most cities compared with rural municipalities and in individuals with common, less severe conditions according to ICD-10 and DRGs compared with life-threatening conditions or dementia. In multivariable analysis, gender (OR; 95% CI: 0.95; 0.93–0.98), social hardship status (1.19; 1.17–1.21), federal state (Brandenburg 0.57; 0.56–0.59; Mecklenburg-Vorpommern: 0.66; 0.64–0.67) and age significantly affected utilization (0.95; 0.95–0.95/year). Conclusions Patient-related and healthcare factors determine the utilization of prosthetic services in very old Germans. Interventions to maintain sufficient prosthetic care up to high age are required. Clinical significance The utilization of prosthetic services in the very old in Northeast Germany showed significant disparities within populations and service types. There seems to be great need to better understand the drivers of utilization, and to develop and evaluate interventions to maintain sufficient prosthetic care up to high age.

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Factors influencing the utilization of dental services in East Java, Indonesia

F1000Research ◽

10.12688/f1000research.23698.1 ◽

2020 ◽

Vol 9 ◽

pp. 673

Author(s):

Ninuk Hariyani ◽

Dini Setyowati ◽

Multia Ranum Sari ◽

Diah Ayu Maharani ◽

Rahul Nair ◽

...

Keyword(s):

Service Utilization ◽

Sex Education ◽

Dental Treatment ◽

Insurance Coverage ◽

Secondary Analysis ◽

Residential Location ◽

Dental Service ◽

Tooth Brushing ◽

Dental Services ◽

Utilization Of Dental Services

Background: Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test some indicators for dental service utilization among East Java residents. Methods: A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5–100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95%CI). Results: Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25–50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79–0.84], PR [95% CI] = 0.89 [0.86–0.93] and PR [95% CI] = 0.91 [0.88–0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16–1.66). Conclusions: Age, sex, education and residential location influence the utilization of dental services among Indonesia’s East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.

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Edentulism and Trajectories of Cognitive Functioning Among Older Adults: The Role of Dental Care Service Utilization

Journal of Aging and Health ◽

10.1177/0898264319851654 ◽

2019 ◽

Vol 32 (7-8) ◽

pp. 744-752 ◽

Cited By ~ 1

Author(s):

Sae Hwang Han ◽

Bei Wu ◽

Jeffrey A. Burr

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Cognitive Functioning ◽

Service Utilization ◽

Dental Care ◽

Care Service ◽

Health Care Expenditures ◽

Self Report ◽

Dental Services

Objective: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults. Method: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline ( N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years. Results: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline. Discussion: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures.

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Dental Service Utilization of a Rural Population in Nigeria

International Journal of Dentistry Research ◽

10.31254/dentistry.2019.4206 ◽

2019 ◽

Vol 4 (2) ◽

pp. 62-65

Author(s):

O.O Osadolor ◽

◽

E.A Akaji ◽

U Otakhoigbogie ◽

H.C Amuta ◽

...

Keyword(s):

Service Utilization ◽

Dental Care ◽

Rural Population ◽

Household Income ◽

Dental Health ◽

Health Centre ◽

Dental Service ◽

Dental Clinic ◽

Dental Services ◽

Socio Demographic Factors

Background: Dental health is often neglected by a vast majority of the population and has contributed to the global burden of oral diseases. Prevention of disease, disability and suffering should be a primary goal of any society that hopes to provide a decent quality of life for its people. Dental care/service utilization is an indispensable facilitator of oral health, as dental caries and gingivitis are preventable with regular access to preventive dental services. Several reasons have been attributed to use and non-use of dental services and include socio-demographic factors such as age, sex, educational attainment, and household income. Objective: To determine dental service utilization of a rural population in South-east Nigeria. Methodology: A cross sectional study of 268 participants was carried out at Ozalla Model Primary Health Centre, Ozalla Health Centre and Umueze Awkunanaw Health Centre located in Ozalla community and Umueze Awkunanaw community respectively. Ethical clearance for this study was sought and obtained. Permission was sought from the head of each health centre, while individual verbal consent was obtained from the respondents before giving out the pretested questionnaire which was interviewer-administered. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 20. Results: 126(47 %) males and 142(53%) females were seen. The age of the participants ranged from 18 - 86 years with a mean age of 32.4 ± 13.3 years. 131(48.9%) were married, 133(49.6%) were single and 4(1.5%) were divorced. 39(14.6%) had only primary level of education, 142(52.6%) secondary, 67(25.0%) tertiary and 21(7.8%) had no formal education. 64(23.9%) had utilized dental service, while 204(76.1%) had not visited a dental clinic (had not utilized dental service). The common reason for dental service utilization was dental pain. The predominant occupation was farming and small scale business/trading. P= 0.038. Conclusion: Dental health was neglected by a vast majority of the participants, The poor utilization of dental service by the respondents could be due to poor awareness, absence of dental insurance, financial constraints , lack of perceived need for dental care, economic difficulties ,socio-demographic factors such as age, sex, educational attainment, and household income. Effort needs to be applied to create better awareness and possibly increase dental clinic attendance. Emphasis should be placed on benefits of utilizing preventive dental services rather than only curative through dental awareness programms.

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Determinants of Dental Care Attendance during Pregnancy: A Systematic Review

Caries Research ◽

10.1159/000481407 ◽

2018 ◽

Vol 52 (1-2) ◽

pp. 139-152 ◽

Cited By ~ 13

Author(s):

Juliana Schaia Rocha ◽

Letícia Yumi Arima ◽

Renata Iani Werneck ◽

Samuel Jorge Moysés ◽

Márcia Helena Baldani

Keyword(s):

Oral Health ◽

Latin American ◽

Dental Care ◽

Dental Service ◽

Behavioral Factors ◽

Service Usage ◽

Dental Services ◽

Perceived Need ◽

Utilization Of Dental Services ◽

Year 2000

Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review.

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Costs for Statutorily Insured Dental Services in Older Germans 2012–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126669 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6669

Author(s):

Aleksander Krasowski ◽

Joachim Krois ◽

Sebastian Paris ◽

Adelheid Kuhlmey ◽

Hendrik Meyer-Lueckel ◽

...

Keyword(s):

General Health ◽

Preventive Services ◽

The Elderly ◽

Disease Classification ◽

Health Conditions ◽

Dental Services ◽

Policy Makers ◽

Very Old ◽

Outreach Services ◽

Icd 10

Objectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs for: (1) examination, assessments and advice, (2) operative, (3) surgical, (4) prosthetic, (5) periodontal, (6) preventive and (7) outreach services. Association of utilization with: (1) sex, (2) age, (3) region, (4) social hardship status, (5) International Disease Classification (ICD-10) diagnoses and (6) Diagnoses Related Groups (DRGs) was explored. Results: 404,610 individuals with a mean (standard deviation, SD) age 81.9 (5.4 years) were followed, 173,733 did not survive follow-up. Total mean costs were 129.61 (310.97) euro per capita; the highest costs were for prosthetic (54.40, SD 242.89 euro) and operative services (28.40, SD 68.38 euro), examination/advice (21.15, SD 28.77 euro), prevention (13.31, SD 49.79 euro), surgery (5.91, SD 23.91 euro), outreach (4.81, SD 28.56 euro) and periodontal services (1.64, SD 7.39 euro). The introduction of new fee items for outreach and preventive services between 2012 and 2017 was reflected in costs. Total costs decreased with increasing age, and this was also found for all service blocks except outreach and preventive services. Costs were higher in those with social hardship status, and in Berlin than Brandenburg and Mecklenburg-Western Pomerania. Certain general health conditions were associated with increased or decreased costs. Conclusions: Costs were associated with sex, social hardship status, place of living and general health conditions. Clinical significance: Dental services costs for the elderly in Germany are unequally distributed and, up to a certain age or health status, generated by invasive interventions mainly. Policy makers should incentivize preventive services earlier on and aim to distribute expenses more equally.

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Social backgrounds, oral behaviors and dental service utilization among Thai older adults: data from the national oral health survey

Journal of Health Research ◽

10.1108/jhr-11-2019-0253 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Punkanit Harirugsakul ◽

Issarapong Kaewkamnerdpong ◽

Sudaduang Krisdapong ◽

Piyada Prasertsom ◽

Kornkamol Niyomsilp ◽

...

Keyword(s):

Older Adults ◽

Oral Health ◽

Service Utilization ◽

Health Survey ◽

Social Background ◽

Dental Service ◽

Dental Services ◽

Cross Sectional ◽

Content Type ◽

Social Backgrounds

PurposeThe number of older adults in Thailand is currently increasing. To create the appropriate oral health service for this age group requires an understanding of the factors that are associated with their dental service utilization. This study aimed to determine the associations between social backgrounds, oral behaviors and dental service utilization among Thai older adults.Design/methodology/approachThis was a cross-sectional study on a representative sample of older adults in the 8th Thai National Oral Health Survey (TNOHS). Data of 4,130 Thai older adults were collected through interviews. The association between social backgrounds, oral behaviors and dental service utilization were investigated using chi-square and logistic regression models.FindingsOf the older adults aged 60–74 years old, 38.4% had used dental services in the last 12 months. Smokers used dental services the least (32.1%). Location, income, education and social welfare were significantly associated with dental service utilization. Among the oral behaviors evaluated, smoking was significantly associated with low dental service utilization.Originality/valueThai older adults with a poor social background including location, income, education, entitlement to the Universal Coverage Scheme (UCS) and smoking made less use of dental services.

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The association of knowledge on oral health and utilization of dental services among pregnant women

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n6p1 ◽

2019 ◽

Vol 9 (6) ◽

pp. 1

Author(s):

Ola Mousa ◽

Asmaa Hamed ◽

Norah Al Omar

Keyword(s):

Oral Health ◽

Pregnant Women ◽

Dental Service ◽

Dental Services ◽

Cross Sectional ◽

Dental Floss ◽

Expectant Mothers ◽

Level Of Knowledge ◽

High Level ◽

Utilization Of Dental Services

Good oral health during pregnancy can possibly reduce complications and this will improve the quality of life of the pregnant woman. In addition, this will prevent the risk of the child to develop early childhood dental caries in the future. The main objective of this study was to determine if there is an association existingbetween the level of knowledge on oral health and utilization of dental services among pregnant women. Furthermore, the study determined the (a) proportion among pregnant women who had high level of knowledge regarding dental careduring pregnancy, (b) proportion of pregnant women who ever visited the dentist during pregnancy, (c) proportions of expecting women who are regularly brushing her teeth and whouses dental floss during pregnancy, and (d) factors that hinders the expecting women from visiting the dentist during pregnancy. A descriptive cross-sectional study was conducted at El Minia University Maternal and Child Health Hospital, El Minia, Egypt. A cross-sectional self-administered questionnaire-based survey was conducted among 200 expectant mothers, approached 156 out of them returned completed questionnaires, representing a response rate of 78%. Results revealed that: (a) nearly 65% of pregnant mothers had a high level of poor knowledge regarding dental care during pregnancy, (b) roughly 24% of pregnant women ever visited the dentist during pregnancy, (c) about 80% and 43% of expecting women regularly brush their teeth at least twice per day and use dental floss during pregnancy, respectively, and (d) among the factors that hinder the expecting women from visiting the dentist during pregnancy include having no time to visit, the consultation cost, fear and anxiety about the procedure, long waiting time, transportation problem and the idea of not needing the dental care. Moreover, the results showed that there was no sufficient evidence to say that the level of knowledge regarding dental service during pregnancy is associated with the utilization of dental service during pregnancy (Pearson Chi-square p-value = .160). The study concludes that health promotion on oral care during prenatal visits should address the mythologies and misconceptions among pregnant women. Therefore, healthcare providers should raise awareness among expectant mothers about giving special attention to oral health needs due to the higher risk of oral diseases that may affect pregnancy and the child inside the womb.

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Factors influencing the utilization of dental services in East Java, Indonesia

F1000Research ◽

10.12688/f1000research.23698.2 ◽

2021 ◽

Vol 9 ◽

pp. 673

Author(s):

Ninuk Hariyani ◽

Dini Setyowati ◽

Multia Ranum Sari ◽

Diah Ayu Maharani ◽

Rahul Nair ◽

...

Keyword(s):

Sex Education ◽

Dental Treatment ◽

Insurance Coverage ◽

Secondary Analysis ◽

Residential Location ◽

Dental Service ◽

Tooth Brushing ◽

Dental Services ◽

Services Utilization ◽

Utilization Of Dental Services

Background : Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test whether certain individual-level sociodemographic, behavioural, and clinical characteristics influenced the current level of dental services utilization by East Java residents. Methods : A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5–100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95% CI). Results : Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25–<50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79–0.84], PR [95% CI] = 0.89 [0.86–0.93] and PR [95% CI] = 0.91 [0.88–0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16–1.66). Conclusions : Age, sex, education and residential location influence the utilization of dental services among Indonesia’s East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.

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GAMBARAN DETERMINAN PERILAKU MASYARAKAT DALAM PEMANFAATAN JASA TUKANG GIGI PADA PEMBUATAN GIGI TIRUAN LEPASAN DI DESA TREMAN KECAMATAN KAUDITAN

e-GIGI ◽

10.35790/eg.2.1.2014.4018 ◽

2014 ◽

Vol 2 (1) ◽

Author(s):

Thirsa O. Lumunon

Keyword(s):

Periodontal Diseases ◽

Economic Factor ◽

Dental Service ◽

Dental Services ◽

Purposive Sampling ◽

Rural Districts ◽

Removable Denture ◽

The Government ◽

The Cost ◽

Utilization Of Dental Services

Abstract: The loss of teeth can be caused by various diseases such as caries and periodontal diseases. This tooth loss can lead to disruption of the speech function, mastication, and aesthetics. Dentures for replacing the missing teeth are important to avoid such impacts. This study aimed to describe the determinants of people's behavior in the utilization of dental services in the manufacture of artisan removable denture in rural districts Kauditan Treman. This was a descriptive study. Taro Yamane formula was used to determine the number of samples. The method of sampling was purposive sampling by using questionnaires to 52 people. The results showed that the primary external factor determinant in the community toward dental service of false teeth makers was the economic factor (the cost of maintenance), meanwhile the internal factor determinant was perception. It is suggested that the government provides more affordable oral health care by adding health personnels, especially the dentists .Keywords: determinants, people's behavior, false teeth makers, removable dentureAbstrak: Kehilangan gigi dapat disebabkan oleh berbagai penyakit seperti karies dan penyakit periodontal yang dapat berakibat terganggunya fungsi bicara, pengunyahan, dan estetika. Pembuatan gigi tiruan untuk menggantikan gigi yang hilang penting dilakukan agar dapat menghindari akibat tersebut. Penelitian ini bertujuan untuk mengetahui gambaran determinan perilaku masyarakat dalam pemanfaatan jasa tukang gigi pada pembuatan gigi tiruan lepasan di desa Treman kecamatan Kauditan. Penelitian ini merupakan penelitian deskriptif. Pengambilan sampel menggunakan rumus Taro Yamane, dan metode pengambilan sampel dilakukan secara purposive sampling dengan membagikan kuesioner pada sampel yang berjumlah 52 orang. Hasil penelitian menunjukkan bahwa determinan penentu utama faktor eksternal masyarakat dalam pemanfaatan jasa tukang gigi untuk pembuatan gigi tiruan lepasan yakni faktor ekonomi, dalam hal ini biaya perawatan; sedangkan determinan penentu faktor internal yakni persepsi. Disarankan pada pemerintah agar dapat menyediakan pelayanan kesehatan gigi dan mulut yang lebih terjangkau oleh masyarakat dengan menambah tenaga kesehatan, khususnya dokter gigi.Kata kunci: determinan, perilaku masyarakat, tukang gigi, gigi tiruan lepasan

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