National Oral Health Policy and Financing and Dental Health Status in 19 Countries

Foote, Tess; Willis, Lauren; Lin, Tracy Kuo

doi:10.1016/j.identj.2023.01.007

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Financing health systems also involves ensuring that funds are accessible where required and creating suitable financial incentives for providers to deliver effective and accessible health services (Irene Papanicolas, Dheepa Rajan, Marina Karanikolos, Agnes Soucat, 2022). Evidence shows that there is a negative association between public coverage and expenditure on OH services and OH outcomes (Foote et al, 2023). As most OH financing comes from private sources, this association possibly does not account for the financial hardship created by incomplete coverage and public funding.…”

Section: Preliminary Discussion and Potential Policy Implicationsmentioning

confidence: 99%

Situation analysis and typology of oral health coverage and financing in Europe – Working paper

Schöner,

Waitzberg

2024

Preprint

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Background and objectives In many countries oral health (OH) services are insufficiently covered by public insurances, which results in financial hardship and OH care being the second main driver of catastrophic health spending in Europe. To suggest feasible and suitable policies that promote the expansion of OH coverage and its integration into health systems, it is imperative to map the current situation of OH coverage and financing. This work aims to perform a situation analysis by mapping the current coverage situation and funding mechanisms of OH care in European countries. It will develop a typology for OH financing and identify market failures, as a baseline for policy recommendations. Methods This study uses qualitative, cross-country, and comparative analysis, based on document analysis. A template was developed based on two analytical frameworks to collect comprehensive and up-to-date data on the coverage and financing of OH services in selected European countries (Denmark, Estonia, France, Germany, Hungary, Ireland, Malta, the Netherlands and Portugal). Data was collected in collaboration with partners from the PRUDENT (Prioritization, incentives and Resource use for sUstainable DENTistry) consortium who consulted health authorities and experts (from e.g. ministries of health, payer agencies, and regulators), and reviewed policy documents from their respective countries. The results presented in this working paper are only preliminary, and include data from Germany, Hungary, Estonia and Denmark. Any interpretation should be made with caution, as this is a working paper. Preliminary results While children mostly receive broader coverage across countries, the degree of coverage varies more for adults. Albeit partially, all countries cover most preventive care and simple treatments such as fillings and extractions, while implants and dentures are either not or only partially covered. Some countries provide special coverage for specific population groups such as chronically ill people or other vulnerable groups such as low-income or disabled. Regarding funding, in many countries (e.g. Germany) there are no earmarked budgets specific for OH. Public OH is financed from the general health budgets, and funds flow through the same mechanisms as other health services: same funds collection methods and sources, same allocation mechanisms to payer agencies, and in many cases, similar methods of payment for providers. Discussion Countries should design OH coverage for populations and services based on their cultural values and priorities. Coverage should be accompanied by sufficient funds to translate in-theory legislation into in-practice availability. It will be important to shape funds collection as progressively as possible and to protect low-income and vulnerable populations from financial hardships. Health systems reforms in funding mechanisms, allocation strategies, and payment mechanisms for OH professionals are essential to mitigate financial barriers and ensure quality care provision.

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Section: Preliminary Discussion and Potential Policy Implicationsmentioning

confidence: 99%

Situation analysis and typology of oral health coverage and financing in Europe – Working paper

Schöner,

Waitzberg

2024

Preprint

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“…Different policies implemented in oral and dental health lead to various executive approaches due to the country’s different political and social conditions [ 14 ]. While tooth decay is overlooked by health policymakers in many countries as one of the most common oral and dental health issues [ 15 , 16 ], oral and dental diseases are recognized as significant factors by policymakers, individuals, and communities in other countries [ 17 ]. Given the aging population as one of the leading global trends, the policies adopted regarding routine dental examinations and dental treatments for the elderly plays a crucial role in preventing health issues, improving the quality of life, and reducing healthcare costs worldwide [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Key factors in the future of oral and dental health in Iran using scenario writing approach

Mehrolhassani,

Mozhdehifard,

Rahimisadegh

2024

BMC Oral Health

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Background Oral and dental health can significantly impact individuals’ quality of life. The World Health Organization introduces oral health as one of the essential priorities of public health worldwide. Given the lack of studies on the future of oral and dental health in Iran, this study used a futures studies approach to identify the factors in oral and dental health in Iran through scenario writing. Methods This study was conducted in three stages including the scenario writing approach, qualitative methods, and exploratory future research. First, potential variables affecting future oral and dental health systems were extracted through interviews. The focus group discussion determined the uncertainty and importance of the variables. Then, the cross-impact balance matrix was imported into the Scenario Wizard software to identify the different states of the scenario generator variables and compatible scenarios were extracted. Results Seventy variables were extracted as key variables affecting the future of oral and dental health. Regarding the importance and uncertainty, seventeen variables scored higher and fell into policy and governance, economy and financing, social, service delivery, and technology, serving as five categories of scenario generators. Fifteen scenarios with weak consistency and three with strong consistency were obtained using the Cross-Impact Balance matrix in Scenario Wizard software. Conclusion The probability of a pessimistic scenario where all five categories of the scenarios were in the worst possible state was higher due to its consistency. The government’s support policies and commitment to oral and dental health were two key factors in the future. Achieving an optimistic and favorable scenario for the future of the country’s oral and dental health system depends on the government and policymakers in the health sector adopting a positive attitude towards the role of oral and dental health services in improving societal health. In this scenario, the five categories of the scenario generators were in the best condition.

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“…These programs achieved improved access to preventive dental care and decreased social inequity. Several governments provided dental services within national health coverage to ease the financial burden as well, such as National Health Services (NHS) or National Health Insurance (NHI) [ 24 – 26 ].…”

Section: Introductionmentioning

confidence: 99%

The role of income and frequency of dental visits in the relationship between dental sealant use and resin fillings after extended coverage: a retrospective cohort study

Han,

Kang,

Ryu

2023

BMC Oral Health

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Background Prevention and treatment services use is closely associated with socioeconomic factors, such as income. This study aimed to investigate the relationship between implementing the sealant program and resin fillings restoration and to explore the role of income and frequency of dental visits in this relationship. Methods This retrospective cohort study used the cohort database from the National Health Information Database of the National Health Insurance Service. The study population comprised 494,731 children born in 2007. A logistic regression model for the experience of resin fillings and a linear regression model for weighted utilization of them were used to identify the independent effects of dental sealants, income, and frequency of dental visits. All analyses were conducted using the SAS Enterprise Guide version 7.1 (SAS Institute Inc., Cary, NC, USA). Results The ratio based on income level was almost proportional in all groups except the medical aid group, which had a rate as high as that of the wealthier group. Children without sealants were 1.05 times more likely to have resin fillings than others after adjusting for income level and frequency of visiting dental clinics in the final model. However, an opposite relationship between sealant experiences and resin fillings was observed in the previous model without dental visits. The gap in the weighted resin filling scores according to socioeconomic variables showed a similar tendency. Conclusions Income and frequency of dental visits might be confounding factors for the relationship between dental sealant and resin fillings. It is necessary to consider the complex relationship between socioeconomic indicators and service use while studying oral health inequality.

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National Oral Health Policy and Financing and Dental Health Status in 19 Countries

Cited by 5 publications

References 17 publications

Situation analysis and typology of oral health coverage and financing in Europe – Working paper

Situation analysis and typology of oral health coverage and financing in Europe – Working paper

Key factors in the future of oral and dental health in Iran using scenario writing approach

The role of income and frequency of dental visits in the relationship between dental sealant use and resin fillings after extended coverage: a retrospective cohort study

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