Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis

Background This study verified the association between contextual and individual factors and public dental services utilisation in Brazil. Methods The study was conducted based on a cross-sectional population-based household survey performed in Brazil (National Health Survey– 2019)). Data was collected between August 2019 and March 2020. Total sample included 43,167 individuals aged ≥15 years who had at least one dental appointment in the last 12 months before interview. Study outcome was ‘public dental service utilisation’, and Andersen’s behavioral model was adopted for selecting independent variables. A multilevel analysis was performed using individual factors as first level and federation units as second level. Results The highest prevalence of public dental service utilisation on an individual level was observed among unable to read or write people (PR: 3.31; p<0.001), indigenous (PR: 1.40; p<0.001), black or brown (PR: 1.16; p<0.001), with per capita household income of up to U$124 (PR: 2.40; p<0.001), living in the rural area (PR: 1.28; p<0.001), and who self-rated oral health as regular (PR: 1.15; p<0.001) or very bad/bad (PR: 1.26; p<0.001). On the contextual level, highest PR of public dental service utilisation was observed among those living in federal units with increased oral health coverage in primary health care. Conclusions Public dental service utilisation is associated with individual and contextual factors. These results can guide decision-making based on evidence from policymakers, demonstrating the potential for mitigating oral health inequalities and increasing service coverage in a public and universal health system.

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Factors related to the use of dental services among adolescents from Gravataí, RS, Brazil, in 2005

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2013000200028 ◽

2013 ◽

Vol 16 (2) ◽

pp. 546-554 ◽

Cited By ~ 4

Author(s):

Rosane Silvia Davoglio ◽

Claídes Abegg ◽

Denise Rangel Ganzo de Castro Aerts

Keyword(s):

Oral Health ◽

Primary Schools ◽

Cox Regression ◽

Individual Factors ◽

Access To Health Services ◽

Cross Sectional Survey ◽

Dental Services ◽

Cross Sectional ◽

Dental Floss ◽

Lower Socioeconomic

Introduction: Access to health services, including those for oral health, depends upon socioeconomic, environmental and individual factors. Moreover, cultural and lifestyle differences also influence the degree to which services are sought. Objective: This study aimed to assess factors associated with the use of dental services among adolescents in the 7th grade of public primary schools from the city of Gravataí, RS, Brazil, in 2005. Methods: A cross-sectional survey was carried out. Data were collected in schools through self-administered questionnaires evaluating demographic, socioeconomic and psychosocial factors, lifestyle, oral health habits and behaviors of 1,170 adolescents, using the Global School-Based Student Health Survey, International Physical Activity Questionnaire and Body Shape Questionnaire. Data analysis was carried out by means of Cox regression modified for cross-sectional studies, using the STATA 6.0 software. Univariate and multivariate analyses were performed from a hierarchical conceptual model supported by the literature on hierarchical models. Results: The use of dental services was less frequent among those who reported concern with body image and involvement in fights; those whose parents did not know where they were in their leisure time, those who brushed their teeth less than twice a day, those who did not use dental floss daily, those who reported seeking dental services for curative treatment and those with a lower socioeconomic status. Conclusions: The results suggest that the use of dental services by adolescents depends upon the interaction of psychosocial and individual factors as well as the family context.

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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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Utilisation of Dental Services of Older People in Australia: An Economic Explanatory Model Based on Cost and Geographic Location

Geriatrics ◽

10.3390/geriatrics6040102 ◽

2021 ◽

Vol 6 (4) ◽

pp. 102

Author(s):

Wisam Kamil ◽

Estie Kruger ◽

Marc Tennant

Keyword(s):

Oral Health ◽

Older People ◽

Cost Model ◽

Geographic Location ◽

Dental Service ◽

Service Utilisation ◽

Ageing Population ◽

Dental Services ◽

Australian Census ◽

Natural Dentition

The increased percentage of older people retaining their natural dentition was associated with a burden of poor oral health and increased service demands. This study analyses the dental service utilisation of the ageing population in Australia and develops a modelled cost design that estimates the dental expenditure required to cover dental services for the aged population. Using the Australian Census of Population and Housing, ageing population and socioeconomic data were mapped to geographic boundaries and integrated with dental service provision data to estimate a model for the utilisation of dental services. The estimated financial cost of dental services was calculated based on the mean fees as per the Australian Dental Association’s Dental Fees Survey. The utilisation of the services varied considerably across the states and also by type of service, with limited numbers using periodontic services. However, there was an increase in cost for replacement and restorative services (5020 million AUD), most evident in the socioeconomic deprivation areas. In addition, the average dental services utilisation cost increased noticeably in the lower socioeconomic deciles of all regions outside major cities. The geographic maldistribution of older people significantly affects the utilisation of dental services, especially among disadvantaged communities. A predicted cost model of 6385 million AUD would cover the oral health needs of older Australians.

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A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

10.1101/2021.05.17.21256858 ◽

2021 ◽

Author(s):

Eric Tranby ◽

Julie Frantsve-Hawley ◽

Myechia Minter-Jordan ◽

James Thommes ◽

Matt Jacob ◽

...

Keyword(s):

Oral Health ◽

Oral Cancer ◽

Dental Care ◽

Care Delivery ◽

Health Spending ◽

Dental Service ◽

Fee For Service ◽

Cross Sectional ◽

Medical Spending ◽

Ibm Watson

Background: Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods): Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results: Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions: This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications: Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.

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Factors related to excessive out-of-pocket expenditures among the ultra-poor after discontinuity of PBF: a cross-sectional study in Burkina Faso

Health Economics Review ◽

10.1186/s13561-020-00293-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yvonne Beaugé ◽

Valéry Ridde ◽

Emmanuel Bonnet ◽

Sidibé Souleymane ◽

Naasegnibe Kuunibe ◽

...

Keyword(s):

Burkina Faso ◽

Financial Risk ◽

Healthcare Services ◽

Cross Sectional Study ◽

Service Utilisation ◽

Health Coverage ◽

Sectional Study ◽

Financial Risk Protection ◽

Cross Sectional ◽

Risk Protection

Abstract Background Measuring progress towards financial risk protection for the poorest is essential within the framework of Universal Health Coverage. The study assessed the level of out-of-pocket expenditure and factors associated with excessive out-of-pocket expenditure among the ultra-poor who had been targeted and exempted within the context of the performance-based financing intervention in Burkina Faso. Ultra-poor were selected based on a community-based approach and provided with an exemption card allowing them to access healthcare services free of charge. Methods We performed a descriptive analysis of the level of out-of-pocket expenditure on formal healthcare services using data from a cross-sectional study conducted in Diébougou district. Multivariate logistic regression was performed to investigate the factors related to excessive out-of-pocket expenditure among the ultra-poor. The analysis was restricted to individuals who reported formal health service utilisation for an illness-episode within the last six months. Excessive spending was defined as having expenditure greater than or equal to two times the median out-of-pocket expenditure. Results Exemption card ownership was reported by 83.64% of the respondents. With an average of FCFA 23051.62 (USD 39.18), the ultra-poor had to supplement a significant amount of out-of-pocket expenditure to receive formal healthcare services at public health facilities which were supposed to be free. The probability of incurring excessive out-of-pocket expenditure was negatively associated with being female (β = − 2.072, p = 0.00, ME = − 0.324; p = 0.000) and having an exemption card (β = − 1.787, p = 0.025; ME = − 0.279, p = 0.014). Conclusions User fee exemptions are associated with reduced out-of-pocket expenditure for the ultra-poor. Our results demonstrate the importance of free care and better implementation of existing exemption policies. The ultra-poor’s elevated risk due to multi-morbidities and severity of illness need to be considered when allocating resources to better address existing inequalities and improve financial risk protection.

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Periodontal condition of adolescents and associated factors

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372019000043489 ◽

2019 ◽

Vol 67 ◽

Author(s):

Marise Fagundes SILVEIRA ◽

Rafael Silveira FREIRE ◽

Maria Fernanda Santos Figueiredo BRITO ◽

Andrea Maria Eleutério de Barros Lima MARTINS ◽

Luiz Francisco MARCOPITO

Keyword(s):

Public Schools ◽

Oral Health ◽

Sampling Method ◽

Population Based ◽

Dental Service ◽

Cluster Sampling ◽

Cross Sectional ◽

Population Based Study ◽

Periodontal Condition ◽

Type Of School

ABSTRACT Objective: This study aimed to describe the periodontal condition of adolescents and identify its potential determinants. Methods: This is a cross-sectional population-based study (n=763) conducted in a city in Northern Minas Gerais. Multistage probability cluster sampling method was used. Trained and calibrated professionals carried out the intraoral examinations and the interviews at the participants’ homes. Logistic regression model was used to identify the factors associated with the periodontal condition. Results: It was found that around 30% of the adolescents presented periodontal changes, being gingival bleeding (14.1%) and dental calculus (14.0%) the most prevalent impairments. Periodontal changes were associated in adolescents who did not attend school (OR=1,9; p=0.031), attended public schools (OR=2,0; p=0.005), never went to the dentist (OR=1,7; p=0,047), used public/philanthropic services (OR=1,7; p=0,002), smoked (OR=1,6; p=0,003), consumed alcohol (OR=1,6; p=0,016) and self-perceived their oral health as too bad/bad (OR=2,4; p=0,032) and regular (OR=1,5; p=0,023). Conclusion: About one-third of adolescents have periodontal changes, which were associated with the type of school and type of dental service they attend, smoking, alcohol consumption and self-perception of oral health.

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Spatial distribuition of tooth loss in a population of adults

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170002000033065 ◽

2017 ◽

Vol 65 (2) ◽

pp. 115-120 ◽

Cited By ~ 2

Author(s):

Manoelito Ferreira SILVA-JUNIOR ◽

Emílio Prado FONSECA ◽

Marília Jesus BATISTA ◽

Maria da Luz Rosário de SOUSA

Keyword(s):

Oral Health ◽

Social Exclusion ◽

Tooth Loss ◽

Epidemiological Data ◽

Epidemiological Survey ◽

Oral Health Status ◽

World Health ◽

Dental Services ◽

Cross Sectional ◽

The Social

ABSTRACT Introduction: Although there has been an improvement in the oral health status of the population, tooth loss still aggravates the oral health of adults and is a matter of great relevance to dentistry. Aim: To determine the spatial distribution of tooth loss in adults and correlate this with the Social Exclusion Index and proximity to public dental services. Material and Method: This ecological study was based on epidemiological data of adults from Piracicaba municipality and from the Piracicaba Research and Planning Institute (IPPLAP). Data on dental evaluations were extracted from the Piracicaba epidemiological survey, which was a cross-sectional study with probabilistic sampling of 248 adults aged 20-64 years, representative of adults living in Piracicaba, Brazil. Oral examinations of the DMFT index were in accordance with the World Health Organization codes and criteria and were performed by a single examiner calibrated for this purpose. Data on social exclusion and the municipal health units that have dental services were extracted from IPPLAP. Georeferencing was performed of census tracts selected by draw, and the city health facilities that have dental services. For Spearman correlation analysis (p <0.05), we used the mean value of teeth lost per district, the Social Exclusion Index (IEX), and proximity to public dental service categorized according to radius: <500m, between 500-1000m, and >1000m the census tract. Result: There was a correlation between tooth loss and higher IEX, and r=−0.51 (p=0.01), but no correlation with proximity to public dental services (p=0.42). Conclusion: Tooth loss in adults was distributed according to social exclusion, however, it was unrelated to proximity to the public dental services.

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Clinical and non-clinical variables associated with preventive and curative dental service utilisation: a cross-sectional study among adolescents and young adults in Central Mexico

BMJ Open ◽

10.1136/bmjopen-2018-027101 ◽

2019 ◽

Vol 9 (9) ◽

pp. e027101 ◽

Cited By ~ 4

Author(s):

Carlo Eduardo Medina-Solís ◽

José Obed García-Cortés ◽

José Luis Robles-Minaya ◽

Juan Fernando Casanova-Rosado ◽

Jairo Mariel-Cárdenas ◽

...

Keyword(s):

Young Adults ◽

Oral Health ◽

Preventive Services ◽

Cross Sectional Study ◽

Adolescents And Young Adults ◽

Caries Experience ◽

Service Utilisation ◽

Use Of Self ◽

Sectional Study ◽

Cross Sectional

ObjectiveThe present study aimed to identify preventive and curative dental health service utilisation (DHSU) in the context of associated clinical and non-clinical factors among adolescents and young adults in Mexico.DesignCross-sectional study.SettingApplicants to a public university in Mexico.ParticipantsParticipants were 638 adolescents and young adults aged 16–25 randomly selected from university applicants.InterventionsData were collected using a self-administered questionnaire filled out by the students. For assessment of dental caries experience, we used the index of decayed, missing and filled teeth.Primary outcomeThe dependent variable was DHSU in the previous 12 months, coded as 0=non-use, 1=use of curative services and 2=use of preventive services.ResultsThe mean age was 18.76±1.76 years, and 49.2% were women. The prevalence of DHSU was 40.9% (95% CI 37.1 to 44.8) for curative services and 22.9% (95% CI 19.7 to 26.3) for preventive services. The variables associated with curative services were age, sex, mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and oral health knowledge. For preventive services, the variables associated were mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and self-perception of oral health.ConclusionsWhile differences emerged by type of service, a number of variables (sociodemographic and socioeconomic characteristics as well as dental factors) remained in the final model. Greater oral health needs and socioeconomic inequalities remained as predictors of both types of DHSU. Given the differences revealed by our study, oral health policies should refer those seeking dental care for oral diseases to preventive services, and promote the use of such services among the poorer and less educated population groups.

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