Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach

Abstract Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Gu...

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Autores principales:	Yuandong Qin, Lin Chen, Jianbo Li, Yunyun Wu, Shaohong Huang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Dental caries Socioeconomic-related oral health inequality Concentration index Welfare policy Dentistry RK1-715
Acceso en línea:	https://doaj.org/article/b037ae63478d4caead4010a9bea887a2
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spelling	oai:doaj.org-article:b037ae63478d4caead4010a9bea887a22021-11-14T12:32:11ZGreater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach10.1186/s12903-021-01935-z1472-6831https://doaj.org/article/b037ae63478d4caead4010a9bea887a22021-11-01T00:00:00Zhttps://doi.org/10.1186/s12903-021-01935-zhttps://doaj.org/toc/1472-6831Abstract Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Guangdong Province. Methods A cross-sectional study was conducted among 35- to 44-year-old and 65- to 74-year-old adults in Guangdong Province. All participants underwent oral health examinations and answered questionnaires about their oral health. We measured the concentration indices of the DMFT and its separate components, namely, decayed teeth (DT), missing teeth (MT), and filled teeth (FT), to explore the inequalities in oral health status; then, we analysed its decomposition to interpret the factors that influence the inequalities. Results The results showed that significant inequality was concentrated on FT (CI = 0.24, 95% CI = 0.14/0.33, SE = 0.05). The concentration indices for the DMFT (CI = 0.02, 95% CI = 0.02/0.06, SE = 0.02) and MT (CI = 0.02, 95% CI 0.03/0.08, SE = 0.03) were small and close to zero, while the concentration for DT (CI = − 0.04, 95% CI = − 0.01/0.02, SE = 0.03) was not statistically significant. The results from the decomposition analysis suggested that a substantial proportion of the inequality was explained by household income, high education level, regular oral examination and type of insurance (5.1%, 12.4%, 43.2%, − 39.6% (Urban Employee Basic Medical Insurance System) and 34.5% (New-Type Rural Medical Collaboration System), respectively). Conclusions The results indicated greater inequalities in dental caries than in caries experience. Among the included factors, household income, high education level, and regular oral health examinations had the greatest impact on the inequalities in the number of FT. In addition, the current medical insurance systems, including the Urban Employee Basic Medical Insurance System, Urban Resident Basic Medical Insurance System, and the New-Type Rural Medical Collaboration System, have not been effectively used in oral treatment. Policy-making and the implementation of interventions for tackling socioeconomic oral health inequalities should focus on reducing the burden of treatment and providing greater access to dental care for low-income groups. Welfare policies are skewed towards rural areas and low-income people.Yuandong QinLin ChenJianbo LiYunyun WuShaohong HuangBMCarticleDental cariesSocioeconomic-related oral health inequalityConcentration indexWelfare policyDentistryRK1-715ENBMC Oral Health, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dental caries Socioeconomic-related oral health inequality Concentration index Welfare policy Dentistry RK1-715
spellingShingle	Dental caries Socioeconomic-related oral health inequality Concentration index Welfare policy Dentistry RK1-715 Yuandong Qin Lin Chen Jianbo Li Yunyun Wu Shaohong Huang Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
description	Abstract Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Guangdong Province. Methods A cross-sectional study was conducted among 35- to 44-year-old and 65- to 74-year-old adults in Guangdong Province. All participants underwent oral health examinations and answered questionnaires about their oral health. We measured the concentration indices of the DMFT and its separate components, namely, decayed teeth (DT), missing teeth (MT), and filled teeth (FT), to explore the inequalities in oral health status; then, we analysed its decomposition to interpret the factors that influence the inequalities. Results The results showed that significant inequality was concentrated on FT (CI = 0.24, 95% CI = 0.14/0.33, SE = 0.05). The concentration indices for the DMFT (CI = 0.02, 95% CI = 0.02/0.06, SE = 0.02) and MT (CI = 0.02, 95% CI 0.03/0.08, SE = 0.03) were small and close to zero, while the concentration for DT (CI = − 0.04, 95% CI = − 0.01/0.02, SE = 0.03) was not statistically significant. The results from the decomposition analysis suggested that a substantial proportion of the inequality was explained by household income, high education level, regular oral examination and type of insurance (5.1%, 12.4%, 43.2%, − 39.6% (Urban Employee Basic Medical Insurance System) and 34.5% (New-Type Rural Medical Collaboration System), respectively). Conclusions The results indicated greater inequalities in dental caries than in caries experience. Among the included factors, household income, high education level, and regular oral health examinations had the greatest impact on the inequalities in the number of FT. In addition, the current medical insurance systems, including the Urban Employee Basic Medical Insurance System, Urban Resident Basic Medical Insurance System, and the New-Type Rural Medical Collaboration System, have not been effectively used in oral treatment. Policy-making and the implementation of interventions for tackling socioeconomic oral health inequalities should focus on reducing the burden of treatment and providing greater access to dental care for low-income groups. Welfare policies are skewed towards rural areas and low-income people.
format	article
author	Yuandong Qin Lin Chen Jianbo Li Yunyun Wu Shaohong Huang
author_facet	Yuandong Qin Lin Chen Jianbo Li Yunyun Wu Shaohong Huang
author_sort	Yuandong Qin
title	Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
title_short	Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
title_full	Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
title_fullStr	Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
title_full_unstemmed	Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
title_sort	greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b037ae63478d4caead4010a9bea887a2
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Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach

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