Macroeconomic changes and trends in dental care utilization in Estonia and Lithuania in 2004–2012: a repeated cross-sectional study

Abstract

BackgroundThe aim of this study was to assess trends and inequalities in dental care utilization in Estonia and Lithuania in relation to large-scale macroeconomic changes in 2004–2012.MethodsData on 22,784 individuals in the 20–64 age group were retrieved from nationally representative cross-sectional surveys in 2004, 2006, 2008, 2010 and 2012. Age- and sex-standardized prevalence estimates of past 12-month dental visits were calculated for each study year, stratified by gender, age group, ethnicity, educational level and economic activity. Multivariable logistic regression analysis was used to assess the independent effect of study year and socioeconomic status on dental visits.ResultsThe age- and sex-standardized prevalence of dental visits in the past 12 months was 46–52% in Estonia and 61–67% in Lithuania. In 2004–2008, the prevalence of dental visits increased by 5.9 percentage points in both countries and fell in 2008–2010 by 3.8 percentage points in Estonia and 4.6 percentage points in Lithuania. In both countries the prevalence of dental care utilization had increased slightly by 2012, although the increase was statistically insignificant. Results from a logistic regression analysis showed that these differences between study years were not explained by differences in socioeconomic status or oral health conditions. Women, the main ethnic group (only in Estonia), and higher educated and employed persons had significantly higher odds of dental visits in both countries, but the odds were lower for 50–64 year olds in Lithuania.ConclusionsIn European Union countries with lower national wealth, the use of dental services is sensitive to macroeconomic changes regardless of the extent of public coverage, at the same time, higher public coverage may not relate to lower inequalities in dental care use.

Self-Reported Oral Health, Oral Hygiene and Associated Factors in Lithuanian Adult Population, 1994–2014

“…People with lower financial resources may lack access to high-quality care. The preceding publication from a Lithuanian health behavior monitoring study reported a strong positive association between education and number of visits to a dentist [36]. According to our data, number of visits to a dentist was associated with number of missing teeth.…”

Inequalities in utilization and provision of dental services: a scoping review

“…At the macro-level, national economic crisis and economic differences between different parts of countries are known factors influencing inequality in utilization and provision of dental services [33,34]. In economic crisis, the rate of utilization decreases, while after that, the situation improves [35]. At the microeconomic level, various concepts such as wealth, poverty, and income have been studied.…”

Prevalence of and factors associated with dental service utilization among early elderly in Lithuania

“…Importantly, the study was performed when the Lithuanian dental health care system was transitioning from centralized Soviet Union model to a two-tier delivery model including both public and private dentistry [ 14 , 15 ]. Moreover, profound macroeconomic changes that occurred in Lithuania in 2004–2012 had a large impact on DSU [ 16 ]. Indeed, a significant increase in dental visits among Lithuanian adults aged 20–64 years in 2004–2008 was followed by a significant decline in 2010.…”

“…Indeed, a significant increase in dental visits among Lithuanian adults aged 20–64 years in 2004–2008 was followed by a significant decline in 2010. A strong positive socioeconomic gradient in DSU was also observed [ 16 ]. However, there is no recent information available on DSU and its related factors in Lithuanian elderly.…”