Pei-Chun Wen1, Chiachi Bonnie Lee2, Ya-Hui Chang3, Li-Jung Elizabeth Ku4, Chung-Yi Li5. 1. National Cheng Kung University, Tainan, Taiwan. peipeinice@gmail.com. 2. China Medical University, Taichung, Taiwan. bonnie1012@mail2000.com.tw. 3. National Cheng Kung University, Tainan, Taiwan. yhccat@gmail.com. 4. National Cheng Kung University, Tainan, Taiwan. eljku@mail.ncku.edu.tw. 5. National Cheng Kung University, Tainan, Taiwan. cyli99@mail.ncku.edu.tw.
Abstract
INTRODUCTION: This study assesses whether demographic and rural-urban variations in dental care service utilization still exist in Taiwan after 15 years of the implementation of universal health insurance coverage, which largely reduces financial barriers to dental care. METHODS: The data analysed in this cohort study were based on a random sample of one million beneficiaries retrieved from Taiwan's National Health Insurance Research Database (NHIRD) in 2005. The follow-up was made between 2005 and 2010. Poisson regression models were used to explore the associations of dental service utilization rates with urbanization and demographic characteristics. RESULTS: The highest and lowest rates of preventive dental care were obtained in people aged 55-64 years (579.2/1000 person-years) and <15 years (178.6/1000 person-years). The corresponding figures for curative care were 1592.0/1000 person-years (<15 years) and 757.2/1000 person-years (35-44 years). Compared with the people living in the least urbanized areas, those from the most urbanized areas presented significantly higher rates of preventive and curative dental services; a greater estimated rate ratio was noted for preventive services than for curative services (1.57 vs 1.42). CONCLUSIONS: The urban-rural disparity in dental care service utilization still exists after 15 years of the implementation of the national health insurance in Taiwan, suggesting that factors other than affordability may play roles in such disparity.
INTRODUCTION: This study assesses whether demographic and rural-urban variations in dental care service utilization still exist in Taiwan after 15 years of the implementation of universal health insurance coverage, which largely reduces financial barriers to dental care. METHODS: The data analysed in this cohort study were based on a random sample of one million beneficiaries retrieved from Taiwan's National Health Insurance Research Database (NHIRD) in 2005. The follow-up was made between 2005 and 2010. Poisson regression models were used to explore the associations of dental service utilization rates with urbanization and demographic characteristics. RESULTS: The highest and lowest rates of preventive dental care were obtained in people aged 55-64 years (579.2/1000 person-years) and <15 years (178.6/1000 person-years). The corresponding figures for curative care were 1592.0/1000 person-years (<15 years) and 757.2/1000 person-years (35-44 years). Compared with the people living in the least urbanized areas, those from the most urbanized areas presented significantly higher rates of preventive and curative dental services; a greater estimated rate ratio was noted for preventive services than for curative services (1.57 vs 1.42). CONCLUSIONS: The urban-rural disparity in dental care service utilization still exists after 15 years of the implementation of the national health insurance in Taiwan, suggesting that factors other than affordability may play roles in such disparity.
Authors: Carlo Eduardo Medina-Solís; José Obed García-Cortés; José Luis Robles-Minaya; Juan Fernando Casanova-Rosado; Jairo Mariel-Cárdenas; María Del Socorro Ruiz-Rodríguez; José de Jesús Navarrete-Hernández; Leticia Ávila-Burgos; Gerardo Maupomé Journal: BMJ Open Date: 2019-09-18 Impact factor: 2.692