scholarly journals Out-Of-Pocket Expenditures on Dental Care for Schoolchildren Aged 6 to 12 Years: A Cross-Sectional Estimate in a Less-Developed Country Setting

Author(s):  
Carlo Eduardo Medina-Solís ◽  
Leticia Ávila-Burgos ◽  
María de Lourdes Márquez-Corona ◽  
June Janette Medina-Solís ◽  
Salvador Eduardo Lucas-Rincón ◽  
...  

Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities–PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US $53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child’s age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US $70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity—as well as those without insurance—face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden.

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
C. Murto ◽  
C. Kaplan ◽  
L. Ariza ◽  
K. Schwarz ◽  
C. H. Alencar ◽  
...  

In Brazil, leprosy is endemic and concentrated in high-risk clusters. Internal migration is common in the country and may influence leprosy transmission and hamper control efforts. We performed a cross-sectional study with two separate analyses evaluating factors associated with migration in Brazil’s Northeast: one among individuals newly diagnosed with leprosy and the other among a clinically unapparent population with no symptoms of leprosy for comparison. We included 394 individuals newly diagnosed with leprosy and 391 from the clinically unapparent population. Of those with leprosy, 258 (65.5%) were birth migrants, 105 (26.6%) were past five-year migrants, and 43 (10.9%) were circular migrants. In multivariate logistic regression, three independent factors were found to be significantly associated with migration among those with leprosy: (1) alcohol consumption, (2) separation from family/friends, and (3) difficulty reaching the healthcare facility. Separation from family/friends was also associated with migration in the clinically unapparent population. The health sector may consider adapting services to meet the needs of migrating populations. Future research is needed to explore risks associated with leprosy susceptibility from life stressors, such as separation from family and friends, access to healthcare facilities, and alcohol consumption to establish causal relationships.


2021 ◽  
Vol 62 (1) ◽  
pp. 5-14
Author(s):  
Natalia Mendes De Matos Cardoso ◽  
Natália Cristina Ruy Carneiro ◽  
Lia Silva de Castilho ◽  
Maria Elisa Souza e Silva ◽  
Ana Cristina Borges-Oliveira

Introduction: Chronic kidney disease (CKD) is a progressive condition characterized by structural or functional abnormalities of the kidney. CKD may be associated with several oral alterations, such as higher prevalence rate of dental caries, periodontal disease, xerostomia, candidiasis and burning mouth. The aim of the study was to identify risk factors associated with edentulism in adults with CKD undergoing hemodialysis. Methods: A cross-sectional study was conducted with 650 individuals aged 18 to 90 years undergoing hemodialysis in southeastern Brazil. Oral clinical examination and administration of a questionnaire addressing demographic characteristics and dental history were performed. The study received approval from the Human Research Ethics Committee of UFMG. Findings: A total of 183 participants were edentulous (28.2%). Individuals with less schooling (OR= 3.99; 95% CI: 2.34-6.79), those who had not been to a dentist in the previous six months (OR = 2.49; 95% CI: 1.52-4.08), those who rated their own smile as excellent or good (OR = 2.00; 95% CI: 1.35-2.97) and those with some mucosal alteration (OR= 4.17; 95% CI: 2.83-6.13) had a greater chance of belonging to the edentulous group. Discussion: The present findings can contribute to the establishment of public health policies aimed at guiding dental care programs for individuals with chronic kidney disease that take into account the specific needs of this population. Conclusion: Edentulism was associated with low schooling, a lack of dental care in the previous six months, a positive self-perception of one’s smile and alterations in the oral mucosa.


2017 ◽  
Vol 94 (4) ◽  
pp. 298-303 ◽  
Author(s):  
Anna Tisler-Sala ◽  
Sven-Erik Ojavee ◽  
Anneli Uusküla

ObjectivesProper antibiotic treatment of STI reduces transmission, antimicrobial resistance and serious disease complications. In this study, we assessed compliance with STI treatment guidelines for genital gonorrhoea and chlamydia infections in Estonia.MethodsPrescription data from the Estonian Health Insurance Fund on 7556 treatment episodes of 6499 patients treated for gonorrhoea or chlamydia during 2012–2014 were analysed to assess compliance with the guidelines and factors associated with it.ResultsBetween 1 January 2012 and 31 December 2014, a total of 6074 patients were treated for chlamydia and 425 for gonorrhoea in Estonia. Among all prescriptions, 48.6% were non-compliant with gonorrhoea treatment guidelines and 3.8% for chlamydia. Non-compliant antibiotic treatment for gonorrhoea was associated with patient gender (female (adjusted OR (AOR)) 3.0, 95% CI 1.6 to 5.9), region (east AOR 3.3, 95% CI 1.3 to 8.2; west AOR 6.5, 95% CI 2.2 to 19.7) and prescribing physician specialty (general healthcare doctors: AOR 5.6, 95% CI 2.3 to 13.8; gynaecologists: AOR 5.9, 95% CI 2.8 to 12.4). Non-compliant antibiotic treatment for chlamydia was associated with younger patient age (15–24 AOR 0.5, 95% CI 0.4 to 0.7), region (north AOR 1.9, 95% CI 1.4 to 2.6; west AOR 2.3, 95% CI 1.5 to 3.4) and multiple treatment episodes (AOR 2.7, 95% CI 2.1 to 3.9). Approximately 14% of prescriptions were multiple treatments for the same patient for the same infection over the 3-year period (6.1% for gonorrhoea and 14.5% for chlamydia).ConclusionThere are significant differences in terms of compliance with treatment guidelines for gonorrhoea and chlamydia, and several factors associated with non-compliance that can potentially be targeted with interventions. Future research should explore reasons clinicians do not follow guidelines and examine ways to improve practice among doctors and patients and assess factors associated with multiple treatments, particularly multiple treatments for the same STI.


2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Hashem Ridha ◽  
Fahed Bouzaber ◽  
Maryam Al-Sallal ◽  
Aisha Almutairi ◽  
Reem Al-dhubaiei ◽  
...  

Abstract Objectives This cross-sectional study assessed the prevalence of self-reported noncompliance with mandatory seatbelt-use law and examined the factors associated with noncompliance with seatbelt-use while driving in adult working population in Kuwait. Methods During October 2017, 822 adults aged 21–60 years from 11 government ministries and departments were enrolled in this study. Data were collected using a pre-tested, structured, and self-administered questionnaire. We computed the prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving and evaluated the factors associated with noncompliance with seatbelt-use law while driving using a multivariable log-binomial regression model. The adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were computed using model’s parameters’ estimates. Results Of 822 participants, 64.4% were females, 56.6% were 21 to 30 years old, 86.5% were Kuwaitis, and 70.3% had college and/or university level education. The prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving was 55.5%, whereas the prevalence of noncompliance with self-reported mandatory use seatbelt as a passenger was 80.9%. Multivariable log-binomial regression model showed that after adjusting for the influence of other variables in the model, participants were more likely to be noncompliers with mandatory seatbelt law while driving, if they believed that seatbelt does not protect against injuries during road traffic crashes (RTC) (adjusted PR = 1.20; 95% CI: 1.06–1.37; p = 0.004) or if they were ever fined for not wearing seatbelt (adjusted PR = 1.34; 95% CI: 1.24–1.47; p <  0.001). Furthermore, participants were significantly more likely to be noncompliers with mandatory seatbelt law while driving, if they were unaware of implemented mandatory seatbelt law in Kuwait (adjusted PR = 1.11; 95% CI: 1.04–1.19; p = 0.003). Conclusions The prevalence of noncompliance with mandatory seatbelt-use law in the adult working population of Kuwait is considerably high. Being unaware of mandatory seatbelt use law, belief that seatbelt does not protect during RTC, and having ever been fined in the past for not having seatbelt on while driving were significant predictors of noncompliance with seatbelt-use law. These results warrant the focused mass education and rigorous enforcement of seatbelt-use law while driving. These strategies are likely to enhance the adherence to seatbelt-use law and minimize RTCs related injuries and mortality among adult drivers in this and other similar settings in the region. If implemented, future studies may look at the impact of such interventions on RTCs related frequency and severity of injuries in this and other similar settings.


2021 ◽  
Author(s):  
Laura Liu ◽  
Zahra Goodarzi ◽  
Aaron Jones ◽  
Ron Posno ◽  
Sharon E Straus ◽  
...  

Abstract Background virtual care has been critical during the COVID-19 pandemic, but there may be inequities in accessing different virtual modalities (i.e. telephone or videoconference). Objective to describe patient-specific factors associated with receiving different virtual care modalities. Design cross-sectional study. Setting and Subjects we reviewed medical records of all patients assessed virtually in the geriatric medicine clinic at St. Michael’s Hospital, Toronto, Canada, between 17 March and 13 July 2020. Methods we derived adjusted odds ratios (OR), risk differences (RDs) and marginal and predicted probabilities, with 95% confidence intervals, from a multivariable logistic regression model, which tested the association between having a videoconference assessment (vs. telephone) and patient age, sex, computer ability, education, frailty (Clinical Frailty Scale score), history of cognitive impairment and immigration history; language of assessment and caregiver involvement in assessment. Results our study included 330 patients (227 telephone and 103 videoconference assessments). The median population age was 83 (Q1–Q3, 76–88) and 45.2% were male. Frailty (adjusted OR 0.62, 0.45–0.85; adjusted RD −0.08, −0.09 to −0.06) and absence of a caregiver (adjusted OR 0.12, 0.06–0.24; adjusted RD −0.35, −0.43 to −0.26) were associated with lower odds of videoconference assessment. Only 32 of 98 (32.7%) patients who independently use a computer participated in videoconference assessments. Conclusions older adults who are frail or lack a caregiver to attend assessments with them may not have equitable access to videoconference-based virtual care. Future research should evaluate interventions that support older adults in accessing videoconference assessments.


Sign in / Sign up

Export Citation Format

Share Document