Abstract
BackgroundsTooth loss is one of the major oral health problems among older Thai people. However, there is the existence of socioeconomic-related inequalities in dental service utilization, especially denture service. The aim of this study was to assess the determinants associated with inequalities in denture service utilization among older Thai people using the Andersen Behavioural model.MethodThis cross-sectional study involved secondary data analysis of the 2014 survey of older Thai people (N = 38,695). The dependent variable was a public denture service utilization over the past 5 years. Determinants were classified as predisposing and enabling factors. Predisposing variables included age, sex, education, economic condition and dependency status. Enabling variables included working status, health behaviours, health care utilization experience and social/community support. Data were analysed by using bivariate and multivariable analyses at α = 0.05. For bivariate analysis, chi-square test was used to determine the association between dependent and each independent variable. Then, all variables were incorporated into a multivariable binary logistic regression.ResultsThe odds of denture service utilization were significantly higher for individuals who were older, female, and had a higher educational level and health-promoting behaviors. A positive dose-response relationship was demonstrated between denture service utilization and increased quartile of household assets.ConclusionsPredisposing variables had a greater impact than enabling variables in denture service utilization among older Thai people. Despite free public denture service, socioeconomic-related inequalities persist. The government needs to reduce socioeconomic disparities to improve denture treatment inequality.
Highlights
Tooth loss is one of the major oral health problems among older Thai people aged 60 years and above [1]
The odds of denture service utilization were significantly higher for individuals who were older, female, and had a higher educational level and health-promoting behaviors
A positive dose-response relationship was demonstrated between denture service utilization and increased quartile of household assets
Summary
Tooth loss is one of the major oral health problems among older Thai people aged 60 years and above [1]. It limits chewing ability and reduces the performance of social functions. The Thai National Oral Health survey during a past decade revealed that approximately 50 and 80% of older Thai people aged 60–74 and above 80 years have less than 20. A universal coverage has been achieved among older Thai people (aged 60 years and above). Older Thai people are eligible for two health insurance schemes; the Civil Servant Medical Benefit Scheme (CSMBS) and the Universal Health Coverage Scheme (UCS) [9, 10]. The CSMBS covers retired civil servant or those with a child/spouse eligible for CSMBS, and the others are eligible for the Limpuangthip et al BMC Oral Health (2019) 19:220
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