Inequalities in Periodontal Disease According to Insurance Schemes in Thailand.

Jarassri Srinarupat,Kornkamol Niyomsilp,Yoko Kawaguchi,Akiko Oshiro,Jun Aida,Takashi Zaitsu,Piyada Prasertsom

doi:10.3390/ijerph18115945

Abstract

Few studies have considered the effects of insurance on periodontal disease. We aimed to investigate the association between insurance schemes and periodontal disease among adults, using Thailand’s National Oral Health Survey (2017) data. A modified Community Periodontal Index was used to measure periodontal disease. Insurance schemes were categorized into the Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and “others”. Poisson regression was applied to estimate the prevalence ratios (PRs) of insurance schemes for periodontal disease, with adjustment for age, gender, residential location, education attainment, and income. The data of 4534 participants (mean age, 39.6 ± 2.9 years; 2194 men, 2340 women) were analyzed. The proportions of participants with gingivitis or periodontitis were 87.6% and 25.9%, respectively. In covariate adjusted models, lowest education (PRs, 1.03; 95% CI, 1.01–1.06) and UCS (PRs, 1.05; 95% CI, 1.02–1.08) yielded significantly higher PRs for gingivitis, whereas lowest education (PRs, 1.20; 95% CI, 1.05–1.37) and UCS (PRs, 1.17; 95% CI, 1.02–1.34) yielded substantially higher PRs for periodontitis. Insurance schemes may be social predictors of periodontal disease. For better oral health, reduced insurance inequalities are required to increase access to regular dental visits and utilization in Thailand.

Highlights

Socioeconomic circumstances, including the health insurance system, affect oral diseases in both developing and developed countries [1]
Few previous studies on social inequalities in oral health have considered the effects of insurance
The objective of the present study was to investigate the association between social circumstances and the occurrence of periodontal disease, by considering insurance schemes among adults, using data from Thailand’s National Oral Health Survey

Summary

Introduction

Socioeconomic circumstances, including the health insurance system, affect oral diseases in both developing and developed countries [1]. Insurance is an important factor in improving access to healthcare. Access to healthcare is influenced by socioeconomic circumstances, such as education and income [2]. Few previous studies on social inequalities in oral health have considered the effects of insurance. This is because the health insurance schemes in many countries do not cover dental care as they do medical care [3]. Even in research on universal health coverage, dental care is rarely considered [4]

Objectives

Discussion

Conclusion