An observational study to find the patterns of out-of-pocket expenditure for oral healthcare among sanitary workers in Coimbatore, India

Abstract

Background: Out-of-pocket (OOP) expenditure for health care and dental care has been steadily increasing. The OOP expenditure may precipitate existing financial distress in the households and lead to unmet dental needs. In India, OOP health expenditure is on the higher side due to low public spending on health. Aim: To find the patterns of oral health-care expenditure, factors associated with catastrophic dental health expenditure (CDHE), and knowledge about health insurance of sanitary workers in Coimbatore, India. Materials and Methods: The study employed a cross-sectional design based on an interview schedule. The final sample consisted of 246 study participants, randomly selected from sanitary workers presently working in Coimbatore Municipal Corporation. Data were collected regarding demographic information, and the interview schedule oral health-care expenditure inventory consisting of 48 questions was administered. Data were coded and analyzed using the Statistical Package for the Social Sciences (SPSS, ver. 20.0), and Chi-square test was applied for categorical variables. Results: The reported prevalence of CDHE was 15.4%. For dental care, 5.3% of the participants have spent more than Rs. 5000/month, and for dental medications, 11% have spent more than Rs. 2000/month. Respondent's monthly income (P < 0.05), number of family members (P < 0.001), socioeconomic status (P < 0.001), monthly expenditure (P < 0.001), duration of work (P < 0.001), dental problems (self-assessment) (P < 0.001), irregular dental visits (P < 0.001), self-medication (P < 0.001), and postponement of dental care (P < 0.001) were significantly associated with CDHE. Conclusions: This study provides evidence that OOP payments for dental care were high among the sanitary workers in Coimbatore putting burden on the financial security of their families, and 15.4% of the respondents were affected by CDHE.