Socio-Economic Disparities in Dental Health and Dental Care Utilisation Among Older Chinese.
Socio-Economic Disparities in Dental Health and Dental Care Utilisation Among Older Chinese.
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中国老年人牙齿健康和牙科保健利用的社会经济差异。
DOI：
10.1111/idj.12600
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发表时间：
2021-03
影响因子：
3.3
通讯作者：
Yao NA
中科院分区：
文献类型：
--
作者：
Li C;Yao NA
在中国，牙科保健基本上不包括在医疗保险范围之内。根据保险类型和社会经济地位，本研究考察了中国老年人在牙科护理和此类护理费用方面的差异。数据来自2015年中国健康与退休纵向研究（CHARLS）。最终样本包括5230名受访者，平均年龄为72岁。无牙性、任何牙科就诊和每位患者牙科护理支出作为结果变量。使用非加权和加权逻辑回归分析来检查社会经济地位（教育，保险类型和收入）与无牙性和牙科护理使用的关联。我们发现，28%的中国老年人没有剩余的牙齿，只有19%的人在过去一年中进行了牙齿护理。未参保和参保农村居民的龋齿率为31%，参保城镇职工的龋齿率为19%。约13%的未参保调查对象和15%的参保农村居民接受过牙科治疗，而参保城市职工的这一比例为30%。那些收入和受教育程度最高的群体，以及那些参加共同保险费率较低的计划的人，比那些社会经济水平最低的群体更有可能使用牙科保健服务，并在牙科保健上花费更多。通过增加参保人口比例和扩大所有三大保险计划所涵盖的牙科治疗范围，可以缩小中国牙科保健的差距。
Dental care is mostly excluded from healthcare coverage in China. This study examines disparities in dental care and in the costs of such care, according to insurance type and socio–economic status, among Chinese older adults. The data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A final sample of 5,230 respondents was included, with a mean age of 72 years. Edentulousness, any dental visit and per-patient dental care expenditure were used as outcome variables. Both unweighted and weighted logistic regression analyses were used to examine the association of socio–economic status (education, insurance type and income) associated with edentulousness and use of dental care. We found that 28% of Chinese older adults have no remaining teeth and that only 19% had used dental care in the past year. The uninsured and those with rural resident insurance had edentulousness rates of 31%, while the edentulousness rate in those with urban employee insurance was 19%. About 13% of the uninsured study respondents and 15% of those with rural resident insurance had used dental care compared with 30% of those with urban employee insurance. Those in the highest income and education groups and those enrolled in a plan with a lower coinsurance rate had a higher likelihood of using dental care services and spending more on dental care than did those in the lowest socio–economic groups. Dental care disparities in China may be reduced through increasing the proportion of the population with insurance and expanding the range of dental treatments covered by all three major insurance schemes.
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