Socio-Economic Determinants of Dental Service Expenditure: Findings from a French National Survey.

Anne-Charlotte Bas,Sylvie Azogui-Lévy

doi:10.3390/ijerph19031310

Abstract

(1) Background: This study investigated how individual enabling resources influence (i) their probability of using dental services and (ii) consumers’ expenditure on dental treatment. (2) Methods: Data were derived from a self-administered national health survey questionnaire and from expenditure data from national health insurance. Multiple linear regression methods were used to analyze entry into the dental health system (yes/no) and, independently, the individual expenditure of dental care users. (3) Results: People with the highest incomes were more likely to use dental service (aOR = 1.59; 95% CI = 1.28, 1.97), as were those with complementary health insurance and the lowest deprivation scores. For people using dental services, good dental health status was associated with less expenditure (−70.81 EUR; 95% CI = −116.53, −25.08). For dental service users, the highest deprivation score was associated with EUR +43.61 dental expenditure (95% CI = −0.15; 87.39). (4) Conclusion: Socioeconomic determinants that were especially important for entry into the dental health service system were relatively insignificant for ongoing service utilization. These results are consistent with our hypothesis of a dental care utilization process in two steps. Public policies in countries with private fees for dentistry should improve the clarity of dental fees and insurance payments.

Highlights

Marked horizontal social inequalities exist in access to dental care: individuals with the same oral health status have different degrees of access to care according to their social status
A total of 59% of the sample did not use dental services at all. Those who did spent an average of EUR 372 on dental care over the year (SD = 763)
Almost 40% of the main sample could be considered as socially deprived, but this figure fell to 34% for the dental services user sample (Table 1)

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Marked horizontal social inequalities exist in access to dental care: individuals with the same oral health status have different degrees of access to care according to their social status. Dental care needs are unmet for financial reasons for 18% of the French population [1], 15% in Europe [2] and from 16 to 35% depending on dental insurance coverage in the U.S [3]. Much has been written on the subject of financial barriers to health-care access, there is little research on dental expenses and the mechanisms by which these barriers hinder utilization

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Discussion

Conclusion