scholarly journals Impact of fees on access to dental care: evidence from France

2020 ◽  
Vol 30 (6) ◽  
pp. 1066-1071
Author(s):  
Anne-Charlotte Bas ◽  
Paul Dourgnon ◽  
Sylvie Azogui-Levy ◽  
Jérôme Wittwer
Keyword(s):  
Health Insurance ◽  
Dental Care ◽  
P Value ◽  
Care Needs ◽  
Enabling Factors ◽  
Healthcare Needs ◽  
Out Of Pocket Payments ◽  
Access To Dental Care ◽  
The Impact ◽  
Dental Prosthetics

Abstract Background For financial reasons, dental prosthetics is one of the major unmet dental healthcare needs [Financial-SUN (F-SUN)]. Private fees for dental prosthetics result in significant out-of-pocket payments for users. This study analyzes the impact of geo-variations in protheses fees on dental F-SUN. Methods Using a nationwide French declarative survey and French National Health Insurance administrative data, we empirically tested the impact of prosthetic fees on dental F-SUN, taking into account several other enabling factors. Our empirical strategy was built on the homogeneous quality of the dental prosthesis selected and used to compute our price index. Results Unmet dental care needs due to financial issues concern not only the poorest but also people with middle incomes. The major finding is the positive association between dental fees and difficulty in gaining access to dental care when other enabling factors are taken into account (median fee in the highest quintile: OR = 1.35; P value = 0.024; 95% CI 1.04–1.76). People with dental F-SUN are those who have to make a greater financial effort due to a low/middle income or a lack of complementary health insurance. For identical financial reasons, the tendency to give up on healthcare increases as health deteriorates. Conclusions The results underscore the need for fee regulation regarding dental prosthetics. This is in line with the current French government dental care reform.

scholarly journals Exploring Variation of Coverage and Access to Dental Care for Adults in 11 European Countries: A Vignette Approach

2021 ◽  
Author(s):  
Juliane Winkelmann ◽  
Jesús Gómez Rossi ◽  
Falk Schwendicke ◽  
Antonia Dimova ◽  
Elka Atanasova ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Systems ◽  
Dental Care ◽  
Cost Sharing ◽  
European Countries ◽  
Access Barriers ◽  
Financial Barriers ◽  
Out Of Pocket Payments ◽  
Access To Dental Care ◽  
The Impact

Abstract Background: Oral health has received increased attention over the past few years coupled with rising awareness on the impact of limited dental care coverage for oral health and general health and well-being. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach.Methods: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists.Results: Completed vignettes were received from 11 countries, including Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different kinds of physical barriers to access dental care. Major access barriers to public dental care represent the limited availability of contracted dentists especially in rural areas and the unequal distribution and lack of specialised dentists.Conclusions: According to the results, statutory coverage of dental care varies across European countries while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries which in turn leads to high out-of-pocket spending. The individual socioeconomic status is thus a main determinant for access to dental care, but also other factors such as geography, age and comorbidities can inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care.

Evaluating the Impact and Effectiveness of Community-Based Health Insurance Policy Among Informal Sector in Lagos State Using Donabedian Model

2021 ◽  
Vol 5 (2) ◽  
pp. 65-80
Author(s):  
Afeez Kolawole Shittu ◽  
Kikelomo Aboyowa Mbada ◽  
Temitayo Isaac Odeyemi
Keyword(s):  
Health Insurance ◽  
Informal Sector ◽  
Urban Areas ◽  
National Level ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Healthcare Needs ◽  
Lagos State ◽  
Donabedian Model ◽  
The Impact

The study used the Donabedian model (process, structure, and outcome) to evaluate the impact and effectiveness of the Community Based Health Insurance Scheme (CBHIS) among informal sector population in rural and semi-urban areas of Lagos State, and the respondents were drawn among the market men and women, motorist, among others. Three hundred and eighty-four (384) respondents were sampled based on the research advisor's sampling size. Lagos State is stratified along with its three senatorial districts and a local government each is purposively selected based on the full implementation of CBHIS. Data were analysed using descriptive and interferential statistics and the result revealed that 55% of respondents attested to the effectiveness of CBHIS in drastically reducing the cost of medical services and enhancing equal accessibility for healthcare needs. On the other hand, the implementation of CBHIS has no significant impact on healthcare service delivery due to the unfriendly attitude of healthcare providers towards the beneficiaries. The study concluded by providing information on the outcomes of CBHIS implementation at the sub-national level of government in Nigeria and suggest ways of improvement.

First steps: Health and social care professionals beginning to address the palliative and end of life care needs of people with diverse gender identities and sexual orientations in Lebanon

Sexualities ◽  
2020 ◽  
pp. 136346072093238
Author(s):  
Claude Chidiac
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Social Stigma ◽  
Life Care ◽  
Care Needs ◽  
Mena Region ◽  
Healthcare Needs ◽  
Health And Social Care ◽  
The Impact

The available evidence demonstrates that lesbian, gay, bisexual, and transgender (LGBT) people face challenges when accessing palliative care services, and receive suboptimal care at the end of life. This is mainly attributed to assumed heterosexuality, lack of knowledge and understanding of LGBT issues and specific healthcare needs, discrimination, homophobia, and transphobia. In Lebanon, legal and institutional support for LGBT individuals is minimal, and palliative care provision remains scarce and fragmented. This compounds the impact of social stigma and marginalisation, and results in unrecognised palliative and end of life care needs for the LGBT individual. This short commentary discusses the development of an LGBT palliative care workshop in Lebanon, which was the first initiative of its kind in the Middle East and North Africa (MENA) region. It also explores how this initiative has led to further developments, and how these efforts can be replicated in other countries in the MENA region.

scholarly journals Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China

2018 ◽  
Vol 14 (4) ◽  
pp. 468-486 ◽  
Author(s):  
Si Ying Tan ◽  
Xun Wu ◽  
Wei Yang
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Rapid Expansion ◽  
Social Health ◽  
Service Utilisation ◽  
Provider Payment ◽  
Out Of Pocket Payments ◽  
The Impact

AbstractWhile moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model. Our results show that Urban Employee Medical Insurance, which offers the most generous benefits, incurs the highest total costs prior to reimbursement when compared to other SHI schemes. Our analysis also shows that utilisation of SHI did not show significant reduction in out-of-pocket payments for outpatients. We argue that, unless effective measures are introduced to deal with perverse provider payment incentives, the move towards a unified system with more generous benefits may usher in a new wave of cost escalation for health care systems in China.

Sociodemographic Characteristics of Mission of Mercy Attendees in Wisconsin

2019 ◽  
Vol 5 (2) ◽  
pp. 127-132
Author(s):  
C. Okunseri ◽  
E. Eggert ◽  
C. Zheng ◽  
F. Eichmiller ◽  
E. Okunseri ◽  
...  
Keyword(s):  
Dental Care ◽  
Dental Health ◽  
The United States ◽  
County Level ◽  
Chi Square ◽  
Access To Dental Care ◽  
Event Location ◽  
Chi Square Test ◽  
Population Ratio ◽  
The Impact

Objective: Mission of Mercy (MoM) events are scheduled to provide care to populations suffering from urgent needs and inadequate access to dental care in the United States. This study examined individual and county-level characteristics of MoM attendees and the factors associated with changes in the rate of attendance. Methods: Deidentified archival data for MoM events available from the America’s Dentists Care Foundation (2013–2016) were analyzed. Summary statistics were calculated separately for each year. Chi-square test was performed to identify changes in attendance distribution over time. Poisson regression analyses were conducted to test changes in the rate of attendance with and without adjustment for county-level characteristics and history of prior MoM events. Results: Total numbers of attendees at Wisconsin MoM events were 1,560, 1,635, 1,187, and 951 in 2013, 2014, 2015, and 2016, respectively. Attendees were mostly female (>50%) and White (58%–81%), and mean age ranged between 36.5 and 39.2 y. The average travel distance ranged between 27 and 80 miles. Residents of counties where MoM events were held in previous years were more likely to attend another MoM event after adjusting for county distance to current location. After adjusting for dentists-to-population ratio, event history, and county distance to event location, we found that there was no statistically significant change in the rate of attendance from 2013 to 2016. Conclusions: Previous attendees with experience of attending a MoM event in their counties of residence were more likely to attend another MoM event. Higher rates of attendance were associated with shorter travel distances to MoM events. Knowledge Transfer Statement: The Mission of Mercy (MoM) events are promoted by local dental organizations to highlight the issue of access to dental care and bring greater awareness to the problem by providing urgent dental care to populations in need. Through the data-sharing practices and analyses, policy makers, dental health advocates, and program organizers will have a better understanding of the impact and reach of the program. Findings from this study will help to expand program practices, promote efficiency, and aid in the identification of appropriate event locations, innovative strategies, and public policies relevant to addressing access to dental care.

scholarly journals The Impact of Expanded National Health Insurance Coverage of Dentures and Dental Implants on Dental Care Utilization among Older Adults in South Korea: A Study Based on the Korean Health Panel Survey

2020 ◽  
Vol 17 (17) ◽  
pp. 6417 ◽  
Author(s):  
Jin-Sun Choi ◽  
Se-Hwan Jung
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Dental Implants ◽  
National Health Insurance ◽  
Dental Care ◽  
Insurance Coverage ◽  
Care Utilization ◽  
Sociodemographic Characteristics ◽  
Panel Survey ◽  
The Impact

In South Korea, the National Health Insurance Service (NHIS) began its coverage of dentures and dental implants for older people in 2012 and 2014, respectively. This study aimed to investigate the impact of these policies on dental care utilization among people aged 65 years or older according to their sociodemographic characteristics. Data were collected from the Korea Health Panel Survey (KHP; years 2012 and 2015). The statistical significance of the relationships between sociodemographic characteristics and the use of outpatient dental care, denture, and dental implant were analyzed. Results showed an increase of 5.7%, 1.4%, and 2.8% in the use of outpatient dental care, denture, and dental implant, respectively, over the course of three years. Including dentures increased its use by 2.5–3.7 times among people aged 70 years or older. Including dental implants alleviated the disparities among older adults based on age groups and duration of education, except those among uneducated people; however, it caused inequity according to household income. Some Korean older adults remain neglected from the benefits of the expanded NHIS. Therefore, older adults’ access to dental care should be enhanced by the implementation of policies to promote oral health care utilization, dental prosthetic services, and older adults’ insurance coverage.

scholarly journals Hubungan Faktor Pemungkin dengan Perilaku Pencarian Pengobatan Anak Jalanan di Kota Bekasi Tahun 2017

2018 ◽  
Vol 46 (2) ◽  
pp. 119-128
Author(s):  
Luna Amalia
Keyword(s):  
Health Insurance ◽  
Street Children ◽  
Good Health ◽  
P Value ◽  
Health Seeking ◽  
Self Medication ◽  
Enabling Factors ◽  
Cross Sectional ◽  
Health Seeking Behavior ◽  
Seeking Behavior

Abstract Street children have a high risk of health problems. This study aims to determine the enabling factors (shelter membership, availability of health insurance, accessibility of health care and social support) associated with the health seeking behavior of street children in Bekasi City. The study design was crosssectional with the sample size of 130 respondents. Analysis results showed that the most of the respondents (82,7%) had poor health seeking behavior. The results of bivariate analyzed showed that the availability of health insurance was significantly associated with health seeking behavior of the street children (p value = 0,054). Street children who had health insurance had an opportunity for good health seeking behavior 2,7 times higher than those who did not have health insurance. It was suggested that data collection of health seeking behavior and the safety of self medication was important as to determine the health needs of street children. Keywords : health seeking behavior, street children Abstrak Anak jalanan memiliki risiko tinggi gangguan kesehatan. Penelitian ini bertujuan untuk mengetahui hubungan faktor pemungkin (kepesertaan rumah singgah, ketersediaan jaminan kesehatan, aksesibilitas pelayanan kesehatan dan dukungan sosial) dengan perilaku pencarian pengobatan anak jalanan di Kota Bekasi. Desain penelitian menggunakan cross sectional dengan jumlah sampel 130 responden. Hasil penelitian menunjukkan bahwa sebagian besar responden (82,7%) melakukan perilaku pencarian pengobatan yang kurang baik. Hasil analisis bivariat menunjukkan bahwa ketersediaan jaminan kesehatan berhubungan signifikan dengan perilaku pencarian pengobatan anak jalanan (p value = 0,054). Anak jalanan yang memiliki jaminan kesehatan, memiliki peluang untuk pencarian pengobatan yang baik sebesar 2,7 kali lebih tinggi dibandingkan anak jalanan yang tidak memiliki jaminan kesehatan. Disarankan pentingnya pendataan anak jalanan dan swamedikasi yang tepat dan aman bagi anak jalanan. Kata kunci : Perilaku, pencarian pengobatan, anak jalanan

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