Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study

Eun Soo Kim, Baek Il Kim, Hoi In Jung

Research output: Contribution to journalArticle

Abstract

Background: In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. Methods: Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010-2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010-2012) and post-policy periods (2014-2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. Results: The prevalence of dental scaling non-users declined from 58.0 to 48.7% in the highest income group and from 86.3 to 78.8% in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95% CI: 11.9-11.9) to 15.5 (95% CI: 15.5-15.5)%, and the adjusted prevalence ratio increased from 1.19 (95% CI: 1.19-1.20) to 1.29 (95% CI: 1.29-1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. Conclusions: The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered.

Original languageEnglish
Article number185
JournalBMC Oral Health
Volume19
Issue number1
DOIs
Publication statusPublished - 2019 Aug 14

Fingerprint

Dental Scaling
Population
Dental Insurance
Dental Care
Tooth
Non-Randomized Controlled Trials
Universal Coverage
Republic of Korea
Health Surveys

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

@article{3de0d6809a844971b55179f68f5fa639,
title = "Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study",
abstract = "Background: In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. Methods: Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010-2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010-2012) and post-policy periods (2014-2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. Results: The prevalence of dental scaling non-users declined from 58.0 to 48.7{\%} in the highest income group and from 86.3 to 78.8{\%} in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95{\%} CI: 11.9-11.9) to 15.5 (95{\%} CI: 15.5-15.5){\%}, and the adjusted prevalence ratio increased from 1.19 (95{\%} CI: 1.19-1.20) to 1.29 (95{\%} CI: 1.29-1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. Conclusions: The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered.",
author = "Kim, {Eun Soo} and Kim, {Baek Il} and Jung, {Hoi In}",
year = "2019",
month = "8",
day = "14",
doi = "10.1186/s12903-019-0881-7",
language = "English",
volume = "19",
journal = "BMC Oral Health",
issn = "1472-6831",
publisher = "BioMed Central",
number = "1",

}

Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study. / Kim, Eun Soo; Kim, Baek Il; Jung, Hoi In.

In: BMC Oral Health, Vol. 19, No. 1, 185, 14.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study

AU - Kim, Eun Soo

AU - Kim, Baek Il

AU - Jung, Hoi In

PY - 2019/8/14

Y1 - 2019/8/14

N2 - Background: In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. Methods: Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010-2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010-2012) and post-policy periods (2014-2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. Results: The prevalence of dental scaling non-users declined from 58.0 to 48.7% in the highest income group and from 86.3 to 78.8% in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95% CI: 11.9-11.9) to 15.5 (95% CI: 15.5-15.5)%, and the adjusted prevalence ratio increased from 1.19 (95% CI: 1.19-1.20) to 1.29 (95% CI: 1.29-1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. Conclusions: The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered.

AB - Background: In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. Methods: Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010-2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010-2012) and post-policy periods (2014-2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. Results: The prevalence of dental scaling non-users declined from 58.0 to 48.7% in the highest income group and from 86.3 to 78.8% in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95% CI: 11.9-11.9) to 15.5 (95% CI: 15.5-15.5)%, and the adjusted prevalence ratio increased from 1.19 (95% CI: 1.19-1.20) to 1.29 (95% CI: 1.29-1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. Conclusions: The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered.

UR - http://www.scopus.com/inward/record.url?scp=85070986030&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070986030&partnerID=8YFLogxK

U2 - 10.1186/s12903-019-0881-7

DO - 10.1186/s12903-019-0881-7

M3 - Article

C2 - 31412821

AN - SCOPUS:85070986030

VL - 19

JO - BMC Oral Health

JF - BMC Oral Health

SN - 1472-6831

IS - 1

M1 - 185

ER -