Samuel López-López1, Raúl Del Pozo-Rubio2,3, Marta Ortega-Ortega4, Francisco Escribano-Sotos5,3. 1. Castilla-La Mancha Health Services, SESCAM, Hospital of Cuenca, C/ Hermandad de Donantes de Sangre, 1, 16 002, Cuenca, Spain. samuel.lopez.lopez1@gmail.com. 2. Department of Economic Analysis and Finance, University of Castilla-La Mancha, Avda. Los Alfares, 44, 16 071, Cuenca, Spain. 3. Research Group on Food, Economy and Society, University of Castilla-La Mancha, Albacete, Spain. 4. Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Campus de Somosaguas s/n, Pozuelo de Alarcón, 28 223, Madrid, Spain. 5. Department of Economic Analysis and Finance, University of Castilla-La Mancha, Plaza de la Universidad s/n, 02 001, Albacete, Spain.
Abstract
OBJECTIVE: To estimate the prevalence of catastrophic health expenditure due to dental healthcare (CHED) in Spain, quantify its intensity and examine the related sociodemographic household characteristics. METHODS: Data from the Spanish Household Budget Survey, which addresses more than 20,000 households each year for the period 2008-2015 were included, and the methodology proposed by Wagstaff and van Doorslaer was followed. The prevalence (number of households that devote more than a certain threshold of their income to such payments) and intensity (amount that exceeds a certain percentage of income) were estimated. Ordered logistic regression models were estimated to analyse the sociodemographic factors associated with the prevalence of catastrophic payments. RESULTS: The prevalence and intensity remained stable during the period under analysis. In terms of prevalence, a mean proportion of 7.36% of the population dedicated, in terms of intensity, more than 10% of their resources to dental care payments [mean: €292.75 per year (SD €2144.14)] and 2.05% dedicated more than 40% [mean: €143.02 per year (SD €1726.42)]. This represents 36.32% and 51.34% (for the thresholds of 10% and 40%) of the total catastrophic expenditure derived from out-of-pocket payments for dental healthcare in Spain. CONCLUSION: This study shows that a significant proportion of catastrophic healthcare payments correspond to dental services. Being male, aged over 40 years, unattached (single, separated, divorced or widowed), having a low level of education, a low household income, being unemployed and living in an urban area are all associated with a greater risk of CHED. This finding highlights the need to establish policies aimed at increasing dental care coverage to mitigate related financial burdens on a large part of the Spanish population.
OBJECTIVE: To estimate the prevalence of catastrophic health expenditure due to dental healthcare (CHED) in Spain, quantify its intensity and examine the related sociodemographic household characteristics. METHODS: Data from the Spanish Household Budget Survey, which addresses more than 20,000 households each year for the period 2008-2015 were included, and the methodology proposed by Wagstaff and van Doorslaer was followed. The prevalence (number of households that devote more than a certain threshold of their income to such payments) and intensity (amount that exceeds a certain percentage of income) were estimated. Ordered logistic regression models were estimated to analyse the sociodemographic factors associated with the prevalence of catastrophic payments. RESULTS: The prevalence and intensity remained stable during the period under analysis. In terms of prevalence, a mean proportion of 7.36% of the population dedicated, in terms of intensity, more than 10% of their resources to dental care payments [mean: €292.75 per year (SD €2144.14)] and 2.05% dedicated more than 40% [mean: €143.02 per year (SD €1726.42)]. This represents 36.32% and 51.34% (for the thresholds of 10% and 40%) of the total catastrophic expenditure derived from out-of-pocket payments for dental healthcare in Spain. CONCLUSION: This study shows that a significant proportion of catastrophic healthcare payments correspond to dental services. Being male, aged over 40 years, unattached (single, separated, divorced or widowed), having a low level of education, a low household income, being unemployed and living in an urban area are all associated with a greater risk of CHED. This finding highlights the need to establish policies aimed at increasing dental care coverage to mitigate related financial burdens on a large part of the Spanish population.
Authors: Enrique Bernal-Delgado; Sandra Garcia-Armesto; Juan Oliva; Fernando Ignacio Sanchez Martinez; Jose Ramon Repullo; Luz Maria Pena-Longobardo; Manuel Ridao-Lopez; Cristina Hernandez-Quevedo Journal: Health Syst Transit Date: 2018-05