Impact of Insurance Scheme on Adults’ Dental Check-Ups in a Developing Oral Health Care System

ABSTRACT

Objectives: To find out the relationship between dental insurance and demand for dental care, the present study evaluated impact of insurance scheme on adults’ dental check-ups in a developing oral health care system.

Methods: The target population included adults in the city of Tehran where the only telecommunication company provides 90% of the 1.9 million households with a fixed telephone. Of the 1531 subjects who answered the phone call, 224 were outside the target age (under 18), 67 said that they never had visited a dentist, and 221 refused to respond, leaving 1019 subjects in the final sample. Each interview lasted 15 minutes and was carried out using a structured questionnaire with fixed and open-ended questions.

Results: 71% of the subjects reported having dental insurance and 16% having visited a dentist for a check-up; 55%, more women than men, reported having had a dental visit within the past 12 months.

Conclusions: The present results revealed the positive relationship between insurance and demand for dental care. Those having dental insurance were more likely to go to check-ups despite their generally low rate found in this country with a developing oral health care system. In such countries, health insurance schemes should therefore include obligatory regular dental check-ups to emphasize prevention-oriented dental care. (Eur J Dent 2008;2:3-10)

Key words:

Adults - Dental check-ups - Dental visit - Demand - Dental insurance

• REFERENCES

• 1 So FHC, Schwarz E. Demand for and utilization of dental services among Hong Kong employees with and without dental benefit coverage. Community Dent Oral Epidemiol 1996; 24: 201-206
• 2 Bendall D, Asubonteng P. The effect of dental insurance on the demand for dental services in the USA: a review. J Manag Med 1995; 9: 55-68
• 3 U.S Department of Health and Human Services. Healthy people 2010. Understanding and improving health. Washington: U.S.Department of Health and Human Services; 2000
• 4 Manning WG, Bailit HL, Benjamin B. et al. The demand for dental care: evidence from a randomised trial in health insurance. J Am Dent Assoc 1985; 110: 895-902
• 5 Brennan DS, Carter K, Stewart J. et al. Commonwealth Dental Health Program Evaluation Report 1994-1996. Adelaide: AIHW Dental statistics and Research unite; Page 94-96
• 6 Locker D, Leake JL. Inequities in health: dental insurance coverage and use of dental services among older Ontario adults. Can J Public Health 1993; 84: 139-140
• 7 Sohn W, Ismail AI. Regular dental visits and dental anxiety in an adult dentate population. J Am DentAssoc 2005; 136: 58-66
• 8 Woolfolk MW, Lang WP, Borgnakke WS. et al. Determining dental checkups frequency. J Am Dent Assoc 1999; 130: 715-723
• 9 Newman JF, Gift HC. Regular pattern of preventive dental services: a measure of access. Soc Sci Med 1992; 35: 997-1001
• 10 Lang WP, Farghaly MM, Ronis DL. The relation of preventive dental behaviors to periodontal health status. J Clin Periodontol 1994; 21: 194-198
• 11 Hayward RA, Meetz HK, Shapiro MF, Freeman HE. Utilization of dental services: 1986 patterns and trends. J Public Health Dent 1989; 49: 147-152
• 12 Helminen SK, Vehkalahti MM. Do check-up intervals correspond to caries indices in the free public dental service in Helsinki, Finland?. Community Dent Health 2002; 19: 166-172
• 13 Tamaki Y, Nomura Y, Teraoka K, Nishikahara F, Motegi M, Tsurumoto A, Hanada N. Characteristics and willingness of patients to pay for regular dental check-ups in Japan. J Oral Sci 2004; 46: 127-133
• 14 Beirne P, Forgie A, Clarkson J, Worthington HV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev 2005; 18: CD004346
• 15 Mettes TG, vander Sanden WJ, Mulder J, Wensing M, Grol RP, Plasschaert AJ. Predictors of recall assignment decisions by general dental practitioners performing routine oral examinations. Eur J Oral Sci 2006; 114: 396-402
• 16 Kiyak HA. Age and culture: influences on oral health behaviour. Int Dent J 1993; 43: 9-16
• 17 Perlus J. Determining recall frequency; A controversial issue. Ontario Dentist 1994; 71: 31-35
• 18 Petersen PE, Holst D. Utilization of dental health services. In Cohen LK, Gift HC. (eds) Disease prevention and oral health promotion: Socio-dental sciences in action. 341-86 Copenhagen, Denmark: Munksgaard International Publisher; 1995
• 19 Abraham D. How dental utilization in The Netherlands was affected by a radical reform of the dental insurance system. Community Dent Health 2003; 20: 34-39
• 20 Schouten BC, Mettes TG, Weeda W, Hoogstraten J. Dental check-up frequency: preferences of Dutch patients. Community Dent Health 2006; 23: 133-139
• 21 Schwarz E, Kronborg D. Utilization of alternative delivery programs in youth dental care in Denmark. Community Dent Oral Epidemiol 1988; 16: 336-340
• 22 Grytten J. Competition and dental services. Health Econ 2000; 9: 447-461
• 23 Nuttall NM, Bradnock G, White D, Morris J, Nunn J. Dental attendance in 1998 and implication for future. Br Dent J 2001; 190: 177-182
• 24 Ronis DL, Lang WP, Farghaly MM, Passow E. Tooth brushing, flossing, and preventive dental visits by Detroit-area residents in relation to demographic and socioeconomic factors. J Public Health Dent 1993; 53: 138-145
• 25 Zhu L. Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J 2005; 55: 231-241
• 26 Zavras D, Economou C, Kyriopoulos J. Factors influencing dental utilisation in Greece. Community Dent Health 2004; 21: 181-188
• 27 Matee M, Simon E. Utilization of dental services in Tanzania before and after the introduction of cost-sharing. Int Dent J 2000; 50: 69-72
• 28 Lo EC, Lin HC, Wang ZJ. Utilization of dental services in Southern China. J Dent Res 2001; 80: 1471-1474
• 29 Chen M, Anderson RM, Barmes DE. et al. Comparing oral health care systems; a second international collaborative study. Geneva: World Health Organization; 1997
• 30 Iran statistical yearbook. Tehran: Statistical Centre of Iran; 2003. Available at: http://www.sci.org.ir/farsi/default.htm..
• 31 Social Security Organization.. Cure Deputy of SSO, list of contracted dentist. Available at: www2.darman.sso.ir.
• 32 Medical Service Insurance Organization. Contracted health care centers, List of contracted clinics and dentists. Available at: http://msio.org.ir.
• 33 Medical Council of Iran. Available at: www.irimc.org.
• 34 Tseveenjav B. Preventive dentistry in Mongolia. Academic dissertation. Helsinki: University of Helsinki; 2004. Available at: http://ethesis.helsinki.fi/julkaisut/laa/hamma/vk/tseveenjav..
• 35 Suominen-Taipale A. Demand for oral health care services in adult Finns. Academic dissertation. Turku: University of Turku; 2000
• 36 Bayat F, Vehkalahti MM, Tala H, Zafarmand HA. Dental attendance by insurance status among adults in Tehran, Iran. Int Dent J 2006; 56: 338-344
• 37 Carter KD, Stewart JF. National Telephone Interview Survey 2002. AIHW Cat No 128. Adelaid: AIHWDental Statistics and Research Unit, the University of Adelaide; 2003
• 38 Batchelor PA. Changes in self-reported attendance of British adults for dental check-ups between 1991 and 2000. Prim Dent Care 2004; 11: 125-130
• 39 Schwarz E. Changes in demand for dental care among Danish adults, 1975-90. Acta Odontol Scand 1996; 54: 36-43
• 40 Anderson R, Marcus M, Mahshigan M. A comparative systems perspective on oral health promotion and disease prevention. In Cohen LK, Gift HC. (eds) Oral Health Promotion: Socio-dental Sciences in Action. pp 307-340 Copenhagen: Munksgaard International Publishers; 1995
• 41 Birch S, Anderson R. Financing and delivering Oral Health Care: what can we learn from other countries?. J Can Dent Assoc 2005; 71: 243-243d
• 42 Pakshir HR. Oral health in Iran. Int Dent J 2004; 54: 367-372
• 43 WHO statistical information system. Total expenditure on health as percentage of gross domestic product. 2004 Available at: http://www.who.int/countries/irn/en/.
• 44 Aljunid SM. Health financing in Iran, Source of funding for health financing in Iran 1980-2001. World Health Organization, Eastern Mediterranean Region Iran Country Office;
• 45 Douglas E. Validity of Telephone Interview Data for Vascular Disease Risk Factors in a Racially Mixed Urban Community. The Northern Manhattan Stroke Study Neuroepidemiology 1999; 18: 174-184
• 46 Ezzati-Rice T, Cynamon M, Blumberg S. et al. Use of an existing sampling frame to collection broad based health and health related data at the state and local level. National center for health statistics 1997. available at; www.cdc.gov/nchs/data/slaits/slaits_tele_survey.pdf