Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;51(4):660-670.
doi: 10.1111/cdoe.12884. Epub 2023 Jun 23.

Inequalities in dental service utilization among Thai adults from 2000 to 2017

Nichamon Chaianant  1 , Teerawat Tussanapirom  2 , Matana Kettratad  3 , Piyada Prasertsom  4 , Warangkana Vejvithee  4 , Kornkamol Niyomsilp  4 , Srisuda Leelasithorn  4 , Piyada Gaewkhiew  2
Affiliations

Inequalities in dental service utilization among Thai adults from 2000 to 2017

Nichamon Chaianant et al. Community Dent Oral Epidemiol. 2023 Aug.

Abstract

Objectives: The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to evaluate socioeconomic inequalities in dental service utilization (DU) before and after UCS implementation and to assess factors associated with DU among Thai adults.

Methods: This study is based on secondary data from four Thai national oral health surveys in 2000-2001, 2006-2007, 2012 and 2017. Whether an individual from a nationally representative sample of Thai adults aged 35-44 went to see the dentist during the past year was used to define DU. The slope index of inequality (SII) and relative index of inequality (RII) were used to assess and compare education and income-related inequalities in DU. Poisson regression was used to assess factors associated with DU. Income inequalities were not reported for the year 2001 (Income data not available).

Results: Although DU increased after UCS implementation, socioeconomic inequalities persisted. DU was concentrated among high-education and income groups. Absolute educational inequalities were 0.16 (95% CI: 0.09-0.22), 0.21 (95% CI: 0.10-0.32), 0.26 (95% CI: 0.14-0.38) and 0.25 (95% CI: 0.18-0.32) in 2001, 2007, 2012 and 2017, respectively. Absolute income inequalities were 0.15 (95% CI: 0.04-0.26), 0.07 (95% CI: -0.04-0.18) and 0.12 (95% CI: 0.05-0.19) in 2007, 2012 and 2017, respectively. Occupation, type of health insurance scheme, sex and oral health-related behaviour were associated with DU.

Conclusion: UCS has improved accessibility to dental services, but UCS alone might not narrow the inequalities gap for Thai adults.

Keywords: adults; dental service utilization; health inequality; oral health survey; universal coverage; working age.

PubMed Disclaimer

References

REFERENCES

    1. Healthy systems for universal health coverage - a joint vision for healthy lives. World Health Organization and International Bank for Reconstruction and Development 2017.
    1. FDI World Dental Federation. Universal Health Coverage: Oral Health for All; September 30, 2022. https://www.fdiworlddental.org/sites/default/files/2020-11/fact_sheet-20...
    1. Bernabé E, Masood M, Vujicic M. The impact of out-of-pocket payments for dental care on household finances in low and middle income countries. BMC Public Health. 2017;17(1):109. doi:10.1186/s12889-017-4042-0
    1. Wang TT, Mathur MR, Schmidt H. Universal health coverage, oral health, equity and personal responsibility. Bull World Health Organ. 2020;98(10):719-721. doi:10.2471/BLT.19.247288
    1. Ettelt S, Nolte E, Mays N. Coverage of publicly-funded dental services - an international perspective. 2009. A Report Commissioned by the Department of Health and Prepared by the London School of Hygiene and Tropical Medicine. https://researchonline.lshtm.ac.uk/id/eprint/5512/

Publication types

LinkOut - more resources