Short-term effects of reduced cost sharing on childhood dental care utilization and dental caries prevention in Japan
Short-term effects of reduced cost sharing on childhood dental care utilization and dental caries prevention in Japan
复制标题
减少费用分摊对日本儿童牙科护理利用和龋齿预防的短期影响
DOI：
10.1111/cdoe.12730
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Yasunaga H.
中科院分区：
文献类型：
--
作者：
Ono S;Sasabuchi Y;Ishimaru M;Ono Y;Matsui H;Yasunaga H.
目的：慷慨的牙科保险可以改善儿童的口腔健康。然而，大多数先前的研究都来自美国，结果可能不适用于具有全民医疗保健系统的国家。本研究的目的是探讨牙科补贴对学龄儿童牙科服务利用和口腔健康的影响。方法使用2014 - 2015年日本熊本县行政索赔数据库进行研究。选择了牙科补贴资格年龄上限为9岁或以上的州。采用差异中差异的方法，调查了停止补贴对牙科保健利用和龋齿预防的影响。牙科保健利用率是通过首次就诊次数、总就诊次数和每次就诊的牙科保健费用来衡量的。确定治疗急性严重的牙科conditions.ResultsDuring的研究期间，1108名符合条件的儿童共6276访问455选定的牙科诊所龋齿预防失败。在牙科诊所中，有230家（50.5%）位于儿童年满10岁时停止提供牙科补贴的城市。在调整了地区收入和最低使用费后，随后的牙科保健利用率没有显着差异（首次访视的平均比值为1.01，95%置信区间[CI]为0.97-1.04;平均比率1.01，总访视的95% CI 0.98-1.05），急性重度牙科疾病（平均比值1.06，95% CI 0.90-1.24）或成本（系数0.7美元; 95%CI −0.2-1.6）结论现行的牙科补贴政策对促进老年人的牙科保健利用和改善口腔健康的价值有限。日本的学龄儿童
ObjectivesGenerous dental insurance coverage can improve oral health among children. However, most previous studies were from the United States, and the results may not be applicable to countries with universal healthcare systems. The purpose of the present study was to examine the effect of dental subsidy on dental service utilization and oral health among school‐aged children.MethodsAn administrative claims database in Kumamoto Prefecture, Japan, between 2014 and 2015 was used for the study. Municipalities in which the upper age limit of qualification for the dental subsidy was either 9 years of age or older were selected. The difference‐in‐differences approach was used to investigate the impact of subsidy discontinuation on dental care utilization and dental caries prevention. Dental care utilization was measured by number of first visits, number of total visits, and dental care cost per visit. Failure in dental caries prevention was determined by identifying treatment for acute severe dental conditions.ResultsDuring the study period, 1108 eligible children made a total of 6276 visits to the 455 selected dental clinics. Among the dental clinics, 230 (50.5%) were located in municipalities in which the dental subsidy was discontinued when children reached age 10. After adjusting for area income and minimal user charges, there were no significant differences in subsequent dental care utilization (mean ratio 1.01, 95% confidence interval [CI] 0.97–1.04 for first visits; mean ratio 1.01, 95% CI 0.98–1.05 for total visits), acute severe dental conditions (mean ratio 1.06, 95% CI 0.90–1.24) or cost (coefficient 0.7 US dollars; 95%CI −0.2–1.6) during the 12‐month period following the policy change.ConclusionThe current dental subsidy policy may have limited value for promoting dental care utilization and improving oral health among school‐aged children in Japan.