Density of dental practitioners and access to dental care for the elderly: A multilevel analysis with a view on socio-economic inequality

Lupi-Pégurier, Laurence; Clerc‐Urmès, Isabelle; Abu‐Zaineh, Mohammad; Paraponaris, Alain; Ventelou, Bruno

doi:10.1016/j.healthpol.2011.09.011

Cited by 27 publications

(37 citation statements)

References 29 publications

(25 reference statements)

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“…This finding is consistent with those of a previous study, which indicated that the density of dental practitioners was associated with dental care utilization among French older adults. 23 More specifically, our study shows that an increase of one dentist per 10,000 residents is associated with about a 10 percent increase in odds of having a dental visit among older adults in the community. This result can be explained in terms of predicted probability.…”

Section: Discussionmentioning

confidence: 63%

“…The only exception is a study conducted in France, the results of which showed that low-income older adults were less likely to obtain dental care but that the effects of income on utilization decreased as the density of dental practitioners increased, suggesting that community factors may mitigate the prevailing income-related disparities in health outcomes. 23 To our knowledge, no researchers have examined the association between community-level characteristics and dental care utilization among older U.S. adults.…”

mentioning

confidence: 99%

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Community factors predicting dental care utilization among older adults

Lee¹,

Kim²,

Albert³

et al. 2014

The Journal of the American Dental Association

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Background Few investigators have studied the influence of community factors on dental care utilization among older adults. The authors’ objective in this study was to investigate the effect of community factors on dental care utilization after adjustment for individual factors. Methods Using data from a cross-sectional survey of Ohio residents, the authors assessed dental care utilization in a sample of 2,166 adults aged 65 years or older. They linked individual-level dental care utilization, predisposing factors (age, sex, race or ethnicity, marital status, education), enabling factors (poverty, dental insurance) and need-related factors (physical and mental health problems) with county-level data (socioeconomic environment and health resource environment) from the 2010 Area Health Resource Files (from the U.S. Department of Health and Human Services) and the American Community Survey (from the 2006–2010 U.S. Census). Using multilevel logistic regression models, the authors evaluated the association between dental care utilization and community factors after adjustment for individual factors. Results The results indicated that individual factors such as being female, married and nonpoor and having a higher educational level and private dental insurance were associated with higher odds of having utilized dental care. Furthermore, older adults living in a county with a higher dentist-to-population ratio were more likely to use dental services even after the authors adjusted the results for the individual-level factors (odds ratio = 1.10, P = .03). Conclusions County-level dentist-to-population ratio has independent effects on older adults’ dental care utilization even after adjustment for individual-level characteristics. Practical Implications A comprehensive policy plan is required to intervene at both the individual and community levels to improve dental care utilization among older adults. By understating the factors influencing dental care utilization among older adults, U.S. dentists will be better positioned to meet the dental needs of this population.

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Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 99%

Community factors predicting dental care utilization among older adults

Lee¹,

Kim²,

Albert³

et al. 2014

The Journal of the American Dental Association

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“…These factors can be divided into four main categories: socio-demographic factors, ill health-related factors, service-related factors, and attitude or subjective factors [7]. Socio-demographic factors include sex, age, education, and income [8,9]. Ill health-related factors include number of teeth, general ill health, and functional limitations [10,11].…”

Section: Introductionmentioning

confidence: 99%

Social determinants of denture/bridge use: Japan gerontological evaluation study project cross-sectional study in older Japanese

et al. 2014

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BackgroundStudies suggest that using a denture/bridge may prevent disability in older people. However, not all older people with few remaining teeth use a denture/bridge. This cross-sectional study aimed to examine the social determinants which promote denture/bridge use among older Japanese.MethodsA total of 54,388 (25,630 males and 28,758 females) community-dwelling individuals aged 65 or over, living independently, able to perform daily activities, and with 19 or fewer teeth. The dependent variable was denture/bridge use. Socio-demographics, number of teeth, present illness, social participation, social support, and social networks were used as individual-level independent variables. Data for social capital were aggregated and used as local district (n = 561 for males, n = 562 for females) -level independent variables. Number of dentists working in hospitals/clinics per population and population density were used as municipality (n = 28) -level independent variables. Three-level multilevel Poisson regression analysis was performed for each sex.ResultsHigh equivalent income, low number of teeth, present illness, and living in a municipality with high population density were significantly associated with denture/bridge use in both sexes in the fully adjusted models (p < 0.05). Denture/bridge use was significantly associated with high educational attainment in males and participating in social groups in females in the fully adjusted model (p < 0.05). No significant associations were observed between denture/bridge use and social capital.ConclusionsDenture/bridge use was significantly associated with high economic status and present illness in both sexes, high educational attainment in males, and participation in social groups in females among community-dwelling older Japanese after adjusting for possible confounders.

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“…13 Tal quadro direciona ainda para a redução da procura e/ou demora dos serviços odontológicos, sobretudo por parte dos mais necessitados desse serviço. [9][10][11][16][17][18] Dificuldades financeiras constituem importante aspecto de obstáculo na utilização dos serviços de saúde bucal observada não só em países em desenvolvimento, como o Brasil, mas também em países como a Austrália e França. 13,16 No artigo desenvolvido por SlackSmith et al, 13 entre as barreiras de acesso aos serviços mencionadas pelos idosos participantes do estudo, estavam o custo pelo tratamento, além da distância dos serviços a suas residências.…”

Section: Fatores Associados Ao Acesso Aos Serviços De Saúde Bucalunclassified

“…Na França, baixa renda e ausência de seguro saúde complementar estavam associadas a maior probabilidade de não realizar visitas a dentistas, revelando alta iniquidade de acesso aos serviços de saúde bucal. 16 Outro aspecto importante relaciona-se a informação e escolaridade: a primeira é descrita nos estudos como empecilho para uso dos serviços odontológicos e saúde bucal em geral, 1,10,13 devido ao déficit informacional voltado às populações ou pela escassez dos serviços. 3 Entretanto, a baixa escolaridade também está associada ao menor acesso aos serviços.…”

Section: Fatores Associados Ao Acesso Aos Serviços De Saúde Bucalunclassified

Acessibilidade a serviços de saúde bucal por pessoas idosas: uma revisão integrativa

Austregésilo

Leal

Marques

et al. 2015

Rev. bras. geriatr. gerontol.

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ResumoObjetivo: Analisar as evidências científicas publicadas relacionadas à acessibilidade de pessoas idosas aos serviços de saúde bucal. Metodologia: Utilizaram-se as bases de dados MEDLINE, LILACS e BBO, empregando como descritores: "idoso", "saúde bucal" e "acesso aos serviços de saúde". A busca ocorreu de forma online em pares, incluindo artigos originais na língua portuguesa, inglesa ou espanhola abordando o tema proposto, publicados no período de janeiro de 2005 a novembro de 2012. Resultados: Mostram estudos em diversos países, os quais referem que a fonte regular de cuidados odontológicos é identificada como fator facilitador para a utilização recente dos serviços. Portanto, apontam a necessidade de ampliar o acesso da população idosa a ações e serviços de saúde bucal, associados principalmente a questões socioeconômicas e culturais. Conclusão: É fundamental garantir o acesso e motivar a procura pelo serviço entre idosos, esclarecendo à população a necessidade e a importância do uso de serviços odontológicos. AbstractAim: To analyze the scientific evidence published, relating to accessibility of elderly to oral health services. Methodolog y: Databases MEDLINE, LILACS, BBO were used, employing as descriptors: "elderly", "oral health", "health services accessibility". The search was conducted online in pairs including original articles in Portuguese, English or Spanish on the study theme published between January 2005 and November, 2012. Results: Showed studies in several countries, which refer to the regular source of dental care identified as facilitating factor for the recent use of services. Therefore, they point the need to expand the elderly's access to actions and oral health services, mainly associated socioeconomic and cultural issues. Conclusion: It is essential to ensure access and motivate the demand for service between dentate and edentulous elderly, explaining to the people the need and importance of attending dental services.

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Density of dental practitioners and access to dental care for the elderly: A multilevel analysis with a view on socio-economic inequality

Cited by 27 publications

References 29 publications

Community factors predicting dental care utilization among older adults

Community factors predicting dental care utilization among older adults

Social determinants of denture/bridge use: Japan gerontological evaluation study project cross-sectional study in older Japanese

Acessibilidade a serviços de saúde bucal por pessoas idosas: uma revisão integrativa

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