Does the regional deprivation impact the spatial accessibility to dental care services?

Shin, Hosung; Ahn, Eunsuk

doi:10.1371/journal.pone.0203640

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…General dentists may not routinely provide all dental services, and dental specialists are more likely to practice in higher population density areas that require lengthy travel time for rural residents to access. 28,30,31 This finding that has been replicated among physician specialists, and is associated with worse health outcomes. 32 This is consistent with the lower rate of procedures provided more commonly by dental specialists among rural residents in our sample.…”

Section: Discussionmentioning

confidence: 79%

“…The persistence of differences in procedure type between rural and urban areas could also be attributed to access to dental specialists. General dentists may not routinely provide all dental services, and dental specialists are more likely to practice in higher population density areas that require lengthy travel time for rural residents to access 28,30,31 . This finding that has been replicated among physician specialists, and is associated with worse health outcomes 32 .…”

Section: Discussionmentioning

confidence: 99%

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Variation in dental services by rurality among privately insured adults in the United States

Simon

Ahern

Fox

et al. 2020

J Public Health Dent

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Objectives: Rurality is associated with reduced dental access and worse oral health outcomes. It is unknown whether there is variation in dental services received by rural adults who visit a dentist. Methods: This was a retrospective analysis of claims data from a large private insurer. All individuals who had at least one dental visit in 2018 were included. Patient demographics, whether or not a patient's ZIP code was rural as defined by the Federal Office of Rural Health Policy, as well as ZIP code demographics were collected. Differences in the frequency of dental services received were evaluated using χ 2 tests. Multilevel logistic regressions were used to evaluate the individual and ZIP code-level correlates of receiving a preventive dental procedure, a tooth extraction, or a denture-related dental procedure. Results: Rates of preventive, oral and maxillofacial surgery, and denture-related procedures were higher among rural adults. Accounting for individual age and gender, and ZIP code average income and dentist density, rural dwellers were more likely to receive a preventive procedure [odds ratio (OR) 1.15, P < 0.0001] or tooth extraction (OR 1.08, P < 0.0001), and less likely to have a denturerelated procedure (OR 0.94, P = 0.015) compared to nonrural dwellers. Female gender was the strongest predictor of receiving a preventive procedure (OR 1.30, P < 0.0001). Conclusions: Even among privately insured individuals with known access to dental care, rurality was associated with significant differences in the frequency of various dental procedures. Rural dental patients may have higher needs for oral surgical procedures, even when they have access to preventive care.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Variation in dental services by rurality among privately insured adults in the United States

Simon

Ahern

Fox

et al. 2020

J Public Health Dent

View full text Add to dashboard Cite

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“…For example, low-income children and adolescents have been shown to travel longer distances to receive orthodontic treatment than others [ 11 ]. Users of dental treatment for non-covered services of the National Health Insurance (NHI; hereafter ‘non-NHI-covered’) in South Korea, which includes mostly non-emergency and elective treatments (e.g., implants/orthodontics and dental prostheses) traveled further to receive treatment, bypassing the dental office nearest their residence [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…In terms of the bypass concept, many studies have analyzed the preferences of patients using healthcare services in rural and remote areas [ 14 , 15 , 16 ], at residences and workplaces [ 8 ], in limited groups [ 11 , 17 ], and in a dental setting [ 12 ]. Patient preference in choosing a healthcare institution is based on individual perception and reflects the patient’s healthcare wishes.…”

Section: Introductionmentioning

confidence: 99%

Travel Time for Dental Care Services Based on Patient Preference in South Korea

Cho

Kim

Shin

2022

IJERPH

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This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health Panel from 2008 to 2017 and analyzed each dental service episode. Since the distribution of travel time was skewed to the left, median travel time was analyzed. The association of travel time with services was analyzed via the population-averaged generalized estimating equation (GEE) with the Poisson family. The median of the average travel time per episode was longer for non-National Health Insurance (NHI)-covered services and shorter for NHI-covered services. The first quintile of low-income subjects traveled the longest for all services and utilized dental care the most. In the GEE analysis, travel time was approximately three times longer for implant treatment and gold inlay/resin fillings and >2 times longer for orthodontic care than for NHI-covered services. Patients residing in rural counties traveled for longer than residents of large cities. Income was statistically significant; however, the coefficient was close to zero. Travel time was related to the type of service and reflected patient preference. This was more prominent for expensive non-NHI-covered services than for NHI-covered services. The findings suggest patients’ subjective preferences for dental clinic selection are expressed as rational deliberation considering each individual’s situation.

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“…(4) The impact of the spatial layout of medical facilities on social economics, comprising an evaluation of the impact of spatial equity changes in medical institutions for public health expenditure between 2001 and 2013. Results highlighted the importance of a comparative analysis of variability factors in knowledge management between public and private hospitals [13][14][15]. Previous studies mainly employed structural equation modeling, the DEMATEL method, logistic regression, geographically weighted regression, and geographic information system.…”

Section: Introductionmentioning

confidence: 99%

Differences in Accessibility of Public Health Facilities in Hierarchical Municipalities and the Spatial Pattern Characteristics of Their Services in Doumen District, China

Zhang

Zhou

2021

Land

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This study used the two-step floating catchment area method and potential model to calculate facility accessibility and potential service scope of public health infrastructure distribution, and to evaluate its spatial equity. We applied the Gini coefficient to measure the spatial equilibrium at each level of public health infrastructure in Doumen District, Guangdong, China, from different perspectives. The following results were obtained: (1) Significant spatial differences were observed in the accessibility of public health facilities among different levels; the higher the health facility level, the greater the difference in spatial accessibility. Spatial differences in the accessibility of public health infrastructure at the primary level and higher were distributed in a block-like pattern, while spatial differences in the accessibility of rural health stations were distributed in a circular pattern. Administrative villages tended to have the highest and lowest accessibility of tertiary and secondary hospitals, but not of primary hospitals and rural health stations. The frequencies for administrative villages with the highest and lowest accessibility were 32.8% and 49.6% of the total number of villages in the district, respectively, for tertiary hospitals; 39.2% and 48.8% for secondary hospitals; 19.2% and 24.8% for primary hospitals; 16.8% and 21.6% for rural health stations. (2) The potential service scope was spatially dissociative for tertiary hospitals, and differed more significantly in terms of space for secondary hospitals; the potential service scope of the two overlapped. The potential service scope of primary hospitals was relatively balanced, with strong spatial continuity, while that of rural health service centers was spatially fragmented. The service scope of rural health service centers was mostly consistent with their respective village-level administrative divisions. (3) The higher the level of public health infrastructure, the less balanced its spatial layout. Conversely, the lower the level of public health infrastructure, the more balanced its spatial layout.

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Does the regional deprivation impact the spatial accessibility to dental care services?

Cited by 8 publications

References 26 publications

Variation in dental services by rurality among privately insured adults in the United States

Variation in dental services by rurality among privately insured adults in the United States

Travel Time for Dental Care Services Based on Patient Preference in South Korea

Differences in Accessibility of Public Health Facilities in Hierarchical Municipalities and the Spatial Pattern Characteristics of Their Services in Doumen District, China

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