Varying Manpower Alters Dental Health in a Developing Health Care System

Bayat, Fariborz; Vehkalahti, Miira M.; Akbarzadeh, Alireza; Monajemi, Farshid

doi:10.1016/j.identj.2021.04.003

Cited by 8 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, they may lead to increased inequality in access to VHI [ 14 ]. Complementary dental insurance is often a privilege associated with higher education levels, higher income, and residence in wealthier areas or the capital city [ 14 , 37 , 38 ]. Overall, expanding complementary dental insurance to small groups and offering family or individual coverage in addition to group policies can enhance access for vulnerable populations and promote universal health coverage.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study

Pouraskari,

Yazdani,

Hessari

2024

International Journal of Dentistry

View full text Add to dashboard Cite

Background. Financial protection is crucial for attaining universal health coverage. The inclusion of costly dental services in insurance plans poses a significant challenge for all parties involved in the insurance sector. This study aimed to investigate the challenges of covering dental services by complementary insurance in Iran during 2020–2021. Materials and Methods. This qualitative research was conducted in Iran during 2020–2021. A triangulation of methods and data sources were employed to achieve a comprehensive perspective. In-depth semistructured interviews were conducted on an individual basis, and all national documents, rules, regulations, and instructions pertaining to complementary dental insurance were thoroughly reviewed. Purposeful sampling was used to select participants from all stakeholder groups engaged in dental insurance coverage, including (1) health system policymakers, (2) insurers, (3) policyholders, (4) care providers (dentists), and (5) insured people. Six open-ended questions were formulated to explore various facets of dental insurance, including (1) development, (2) management, (3) population coverage, (4) premium calculation, (5) services coverage, and (6) payment and reimbursement mechanisms. With the consent of the participants, all interviews were recorded and transcribed verbatim. The gathered data were evaluated using a framework analysis approach in the MAXQDA20 software. Finally, the primary themes, each encompassing multiple subthemes, were identified and presented. Results. A total of 26 interviews were conducted with five groups of interviewees, and nine national documents were evaluated. Six themes were extracted, which included 18 codes from the interviews and seven codes from the documents. The extracted themes were as follows: (1) Insurance commitments and service coverage, (2) reimbursement system, (3) information system, (4) economic issues, (5) population coverage, and (6) regulation and supervision. The high cost of dental services was the most frequent challenge, followed by the insurance commitments and service coverage. Conclusions. The delivery of dental services through complementary insurance in Iran primarily faces economic and service coverage challenges. The resolution hinges on the collaboration between basic and complementary insurance sectors, the development of a unified information system for insured individuals, and the implementation of a risk-adjusted premium plan.

show abstract

Section: Discussionmentioning

confidence: 99%

Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study

Pouraskari,

Yazdani,

Hessari

2024

International Journal of Dentistry

View full text Add to dashboard Cite

show abstract

“…A prior national study suggested that individuals with both public and complementary dental insurance utilized high-cost dental treatments and restorations more than other services. Furthermore, this study revealed that preventive care was the least commonly received service [ 13 ]. Contrarily, a prior systematic review on the utilization of dental services in Australia indicated that 83.5% of insured individuals had a history of using scaling services.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations in Iran suggested that people with both public and private health insurance more frequently used restorative and expensive dental services compared to those who only had public health insurance [ 13 ]. Furthermore, adolescents with complementary health insurance exhibited a higher prevalence of decayed and filled teeth, despite their increased utilization of dental services compared to their counterparts [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Patterns and factors associated with dental service utilization among insured people: a data mining approach

Pouraskari,

Yazdani,

Khademi

et al. 2024

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

Background Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology. Methods A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020. Results The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories. Conclusions Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.

show abstract

“…This is while basic insurances pay 3% of the costs of services such as scaling, simple radiography, surface filling, and tooth extraction, and supplementary insurance companies bear 7% of dental costs, and other costs are paid out of pocket by patients [ 13 ]. The Ministry of Health and Medical Education (MOHME), as the main provider of public services, provides some oral and dental health services covered by basic health insurance, mainly in rural areas [ 24 ].On the other hand, the majority of dental services are provided by the private sector, while almost 90% of dentists work in urban areas [ 25 , 26 ]. Recently, the MOHME has made efforts to increase the coverage of dental services; however, it has not entered the implementation phase [ 27 ].…”

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

View full text Add to dashboard Cite

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.

show abstract

Varying Manpower Alters Dental Health in a Developing Health Care System

Cited by 8 publications

References 27 publications

Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study

Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study

Patterns and factors associated with dental service utilization among insured people: a data mining approach

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

Contact Info

Product

Resources

About