The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

Bernabé, Eduardo; Masood, Mohd; Vujicic, Marko

doi:10.1186/s12889-017-4042-0

Cited by 88 publications

(76 citation statements)

References 34 publications

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“…This study shows that around 4% of Peruvian households incurred OOP expenditure, in the past 12 months, that surpassed 40% of their capacity to pay. Although this figure is lower than for other middleincome countries (Bernabe et al 2017), it is very similar to the estimate reported from ENAHO 2006 (5% prevalence using a lower income threshold, 30%) (Knaul et al 2011). Therefore, our findings suggest there has not been much progress in reducing the financial risk of OOP payments for healthcare over the last decade.…”

Section: Discussionsupporting

confidence: 84%

“…In addition, the use of specific healthcare services, such as inpatient care, prescription drugs, dental services, and visits to traditional healers, may lead to CHE (Saksena et al 2010;Kim et al 2011;Brinda et al 2014;Masood et al 2015;Ozgen Narci et al 2015). A multilevel study across 40 low-and-middle income countries showed that all types of healthcare services affected household finances, with a clear divide between OOP payments for drugs, hospitalisation, ambulatory care and tests, on one hand, and, dental care, healthcare products, traditional medicine and other health services, on the other hand (Bernabe et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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Determinants of catastrophic healthcare expenditure in Peru

Falconí

Bernabé

2018

Int J Health Econ Manag.

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The aims of this study were to assess factors associated with catastrophic healthcare expenditure (CHE) and the burden of out-of-pocket (OOP) payments for specific healthcare services in Peru. We used data from 30,966 households that participated in the 2016 National Household Survey (Encuesta Nacional de Hogares, ENAHO). Participants reported household characteristics and expenditure on ten healthcare services. CHE was defined as healthcare spending equal to or higher than 40% of the household's capacity to pay. The associations of various household characteristics and OOP payments for specific healthcare services with CHE were assessed in logistic regression models. Poorer, rural and smaller households as well as those with older adults and individuals with chronic conditions had greater odds of facing CHE. According to the estimates from the adjusted regression model, healthcare services could be grouped into three groups. Medical tests, surgery and medication were in the first group with odds ratios (ORs) between 6.43 and 4.72. Hospitalisation, outpatient, dental and eye care were in the second group with ORs between 2.61 and 1.46. Child care, maternity care and other healthcare services (such as contraceptives, rehabilitation, etc.) were in the third group with non-significant ORs. Many Peruvian households are forced to finance their healthcare through OOP payments, burdening their finances to the extent of affecting their living standards.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Determinants of catastrophic healthcare expenditure in Peru

Falconí

Bernabé

2018

Int J Health Econ Manag.

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“…Another study among adult city-dwellers in Burkina Faso also highlighted cost of dental treatment as the main barrier to dental visits (50). Dental treatment is known to expose households to unpredictable and signi cant nancial costs; recent research has shown, in low income households the larger portion of their disposable income could be used for dental treatment mainly in out-of-pocket payment situations (51). This could also be the case in Ethiopia, as out-of-pocket payment is the main method of funding healthcare (52).…”

Section: Discussionmentioning

confidence: 99%

Dental caries experience in adults: a cross-sectional community survey within Ethiopia

Bogale¹,

Engida²,

Hanlon³

et al. 2020

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Background Ethiopia is a large and diverse developing sub-Saharan African country with increasing prevalence of non-communicable diseases, including oral conditions. Oral health and dental care have been given little consideration, and there is limited information relating to population oral health and use of dental services in the country. The aim of this study was to examine the burden and impact of dental caries experience and investigate access to dental care amongst adults within Ethiopia. Methodology This community-based oral health survey is a baseline study for the ASSET - Health System Strengthening in sub-Saharan Africa project undertaken in the Butajira area, south-central Ethiopia. A stratified random sample of households and individuals were participated in the study. The survey was informed by the World Health Organization (WHO) Oral Health Survey Methods (5th ed.) at International Caries Detection and Assessment System (ICDAS) threshold 4 and the UK Adult Dental Health Survey 2009. Face-to-face interviews and clinical dental examinations were conducted. The data were analysed using descriptive statistics; and a binary logistic regression model was built to assess the association of dental caries and predictor variables: demographics, health behaviours, quality of life, dentition status and consequences of untreated caries data in adults (≥18 years).Result Most of the study population (n=626) were female (63.9%), married (71.4%) and Muslim (76.0%). Just over half (53.2%) lived in rural areas and many (44.4%) had no formal education. A majority (74.0%) reported never attending a dental service. Sixty percent (n=377) of the adults had experienced dental caries, 88.0% (n=332) of whom had untreated carious teeth. In the fully adjusted logistic regression model; increasing age, dental attendance and Khat chewing had a positive significant association with dental caries experience, whilst education status was negatively associated (p<0.05).Conclusion This study demonstrated a high burden of dental caries and considerable impact resulting from untreated disease in this population of adults. There was also evidence of social inequity and limited overall access to dental care, highlighting the need for health system strengthening.

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“…For families living at or below the poverty line, out-of-pocket dental expenses are potentially catastrophic health expenditures. Disposable income is virtually non-existent in these households and so oral health inequalities remain (34). Hence, low-income Canadians may rely on the availability of charitable or community dental clinics to have their needs addressed (2), or end up in hospital emergency rooms for dental pain relieve (35).…”

Section: Mean Very Few People Have Dental Care From the Governmentmentioning

confidence: 99%

Universally funded oral health care and oral health outcomes

Brondani

Mathu‐Muju

Skott

et al. 2019

Preprint

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Objectives To critically review the oral health care systems of four countries with a universal public health care system in terms of structure, scope and delivery and their impact on oral health outcomes. Methods A comparative review on the oral health care systems from Brazil, New Zealand, Canada and Sweden was performed between August 2017 and January 2018 using PubMed/MEDLINE and the key words ‘universal’ AND ‘dental OR oral’ AND ‘care OR access’ AND ‘outcome’. This is a critical essay based on evidence available in the literature and interactive conversations with key informants in all four countries. Results Although all four countries provide universal health care, the administration, funding and delivery of oral health care varied. About 6% of oral health care expenditure in Canada are publicly-funded. Brazil provides free oral health care at the point of use via salaried dental professionals, while Sweden offers a high-cost protection plan favouring those with greater needs, and New Zealand delivers free oral health care to children only up to their 18th birthday. With service utilization varying from 44% to more than 80%, sixty-one percent of Canadian children, 67% of Swedish children, 50% of Brazilian children and 45% of New Zealand children are caries-free at age 12 while 6.4%, 0.8%, 6.5%, and 9.6% of adults between the ages of 20 and 79 years are edentulous, respectively. Conclusions All countries have some form of publicly-funded oral health care, but a wide spectrum of salary-based and private-practice delivery models exists. Services utilization and oral health outcomes differ in each country.

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The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

Cited by 88 publications

References 34 publications

Determinants of catastrophic healthcare expenditure in Peru

Determinants of catastrophic healthcare expenditure in Peru

Dental caries experience in adults: a cross-sectional community survey within Ethiopia

Universally funded oral health care and oral health outcomes

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