Are Public Oral Care Services Evenly Distributed?—Nation-Wide Assessment of the Provision of Oral Care in Japan Using the National Database of Health Insurance Claims

Abstract

The provision of oral health care services is one of the global challenges under the realization of universal health coverage in many countries. Despite the increasing importance of oral health care in an aging society, the disparities in the provision of oral care in Japan have not been clarified. Therefore, this study investigated the status of oral and dental care provision using the National Database of Health Insurance Claims and Specific Health Checkups (NDB) at the level of prefectures and secondary medical care areas. Additionally, a multiple regression model was applied to identify the influence of human resources in oral care services and economic factors on the standardized claims data ratio (SCR) of total dental receipts. The results showed that the total amount of oral care provided tended to be higher in metropolitan areas, with bimodal peaks in children aged 5–9 and adults in their 70s. The SCR for dental caries showed little difference nationally, but SCR for periodontal disease tended to be higher in prefectures including metropolitan areas. In a multiple regression model, the number of dentists and prefectural income per capita influenced the SCR of total dental receipts. In secondary medical care areas, some depopulated areas are supplemented by adjacent areas. These results suggest that oral health care services in the national health insurance system are generally well provided; however, they are likely to be influenced by human resources and economic disparities, and regional differences may occur in the care of periodontal diseases.

Prevalence of root canal treatment worldwide: A systematic review and meta‐analysis

“…The African population shows the lowest prevalence of RFT. The differences in the age of the populations (Jiang et al, 2021 ), the different level of economic development (Bas & Azogui‐Lévy, 2022 ; Listl et al, 2015 ), and the different access to dental health services (Kodama et al, 2021 ) can explain the differences observed between continents. The highest levels of per capita dental expenditures has been found for High‐Income North America, Australasia, Western Europe, High‐Income Asia Pacific, and East Asia (Righolt et al, 2018 ).…”

Validity of Self-Reported Number of Teeth among Independent Older People in Japan

“…In addition, to obtain reliable results, the population should be as large as possible [30]. By contrast, as health checkup and medical-expense receipt data have become digitized, dental studies based on big data such as national databases, which are not intended for epidemiological research, are being conducted [31][32][33]. If the reliability of the data can be ensured, self-reported health conditions will expand the range of research.…”

Associations between school-based fluoride mouth-rinse program, medical-dental expense subsidy policy, and children's oral health in Japan: an ecological study

“…Due to the highly con dential nature of the information contained in the NDB database, various conditions are imposed on the use of the data, which are not freely accessible to researchers. Contrary, NDB-open data is accessible to everyone free of charge and is actually used for several studies (15)(16)(17).…”

“…An SCR score higher than 100 means the prefecture utlilizes speci c medical/dental care more frequently than the mean of Japan as a whole. For detailed SCR calculations, please refer to previous studies (16,17). The information on treatment for dental caries in children such as llings, prosthetics, and dental pulp extractions was unavailable due to the following two reasons: First, NDB-open data does not provide information on medical/dental claims by prefecture for speci c age groups.…”