Abstract
BackgroundThis study aimed to investigate the relationship between complementary health insurance and frequency of dental visits.MethodsThe present study was performed using the Urban Health Equity Assessment and Response Tool (Urban HEART). A cross-sectional study was conducted in Tehran (Iran) to assess inequalities in health status among different socioeconomic and ethnic groups, genders, geographical areas, and social determinants of health. Out of 20,320 records retrieved from the original study with dental information, 17,252 had both dental insurance and dental visit information. Complementary health insurance as the main independent variable had three categories (i.e., basic insurance, with complementary medical coverage, and with dental coverage). The frequency of dental visits during the last year as a dependent variable had also three categories (i.e., no visit, one, and two, or more dental visits in the last year). In this study, in addition to investigating the relationship between complementary health insurance and frequency of dental visits, potential covariates that may affect the mentioned relationship were evaluated in the regression model. Statistical analyses included simple and multiple multinomial logistic regression considering the sampling method and sampling weights.ResultsThe meanage of 17,252 participants (Tehran citizens) was 39.36 years; 49.4%were women, 86.0%hadonly basicinsurance, 7.2% had complementary medical insurance, and 6.8% had complementary dental insurance. Of all subjects, 43.8% reported no dental visit, 26.1% reported one, and 30.1% reportedtwoor more dental visits during the lastyear. The frequency of dental visits was lower in people who had basic insurance than others such that that odds ratio (OR) was 0.73 (p-value < 0.001) for one visit and 0.68 (p-value< 0.001) for two or more visits in the last year. The frequency of dental visits was also positively associated with dental brushing, toothpaste use, high educational level, being married, having more than 20 teeth, and having dental pain.ConclusionHaving dental insurance increases the frequency of dental visits but the association between dental insurance and dental visits was independently influenced by other predictors.
Highlights
This study aimed to investigate the relationship between complementary health insurance and frequency of dental visits
Having dental insurance increases the frequency of dental visits but the association between dental insurance and dental visits was independently influenced by other predictors
Tooth brushing and toothpaste usage were high among subjects as 92% of them announced that they brush their teeth every day and use toothpaste regularly
Summary
This study aimed to investigate the relationship between complementary health insurance and frequency of dental visits. In low and middle-income countries, inequities in health care utilization and outof-pocket expensesare common; the national health care systems try to facilitate benefiting from dental care in several ways such as insurancedevelopment [8]. In this connection, the World Health Organization (WHO) is one ofthe pioneers of improving health insurance [9]. It has been evidenced that factors such as personal and national income [10], health insurance literacy [11],and socioeconomic status [12] can affect the insurance coverage percentage
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