Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping

Holmén, Anders; Strömberg, Ulf; Håkansson, Gunnel; Twetman, Svante

doi:10.1186/s12903-017-0470-6

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…Geomapping, i.e. the geographical mapping of health data, has been described as a new tool to monitor health risk for medical as well as dental health purposes [22][23][24]. In Sweden, this tool has been used not only to illustrate the inequalities in caries risk among children living in Halland region in southwest Sweden but also to evaluate the effects of allocating more money to parishes inhabited by children with increased caries risk [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Caries status of first-born child is a predictor for caries experience in younger siblings

et al. 2021

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Objectives This study analysed if children of families in need of dental interventions can be identified by using the caries status of the first-born child as a predictor for caries in younger siblings of the same family. Material and methods All children aged 4 to 15 years, i.e. 13,596 children, visiting a compulsory school in the canton of Basel-Stadt, Switzerland, during the school year 2017/2018 were analysed. Total caries experience and untreated carious lesions at time of examination were recorded as well as a subset of socioeconomic factors such as gender, age, nationality, birth order and the family’s place of residence. Results A total of 6738 schoolchildren who had at least one sibling of school age could be included. Differences in caries experience and the presence of active carious lesions were found for age, nationality and place of residence but not for gender or birth order. Younger siblings had odds of having a history of caries 3.7 times higher (95% confidence interval: 3.0–4.4) and odds of having active carious lesions 3.5 times higher (95% confidence interval: 2.6–4.7) if the eldest child in the family already had caries. Conclusion Caries could be shown to be family-dependent. Younger siblings had a more than three-fold higher risk for caries if the first-born child already had carious lesions. Clinical relevance Based on these results, the caries status of the first-born child could be used as a potential indicator to detect vulnerable families and to initiate targeted preventive measures.

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Section: Discussionmentioning

confidence: 99%

Caries status of first-born child is a predictor for caries experience in younger siblings

et al. 2021

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“…A study from Glasgow, Scotland, reported that investment in housing-led renewal according to population need leads to modest reductions in area-based health inequalities after 5 years [47]. Additionally, a risk-based capitation model reduced socio-economic inequalities in dental caries among preschool children living in Sweden [48]. These results suggest that proportionate universalism can be an effective strategy to reduce oral health inequalities, but more evidence is necessary.…”

Section: Discussionmentioning

confidence: 99%

Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study

Kim

Jung

2019

BMC Oral Health

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Background In 2013, the national dental scaling insurance policy was introduced in South Korea. The purpose of this study is to determine the impact of the policy on inequalities in dental scaling usage. Methods Data of a nationally representative sample of 1,517,097 people over the age of 20 were obtained from the 2010–2016 Community Health Survey. Respondents who reported that they had not received dental scaling in the past year were defined as dental scaling non-users. The excess prevalence and relative prevalence ratio of dental scaling non-users were calculated for the pre-policy (2010–2012) and post-policy periods (2014–2016) using monthly household income levels. Additionally, trends of dental scaling inequalities were shown as concentration indexes. Results The prevalence of dental scaling non-users declined from 58.0 to 48.7% in the highest income group and from 86.3 to 78.8% in the lowest income group. However, the adjusted excess prevalence for the lowest income group compared with the highest had increased from 11.9 (95% CI: 11.9–11.9) to 15.5 (95% CI: 15.5–15.5)%, and the adjusted prevalence ratio increased from 1.19 (95% CI: 1.19–1.20) to 1.29 (95% CI: 1.29–1.30). Absolute and relative concentration indexes of dental scaling non-users increased after policy implementation. Conclusions The national dental scaling insurance policy has increased socioeconomic inequalities in dental scaling usage. Because dental care access generally requires high individual agency, expanded dental coverage may have had limited effects in attenuating inequalities and inadvertently widened the gap. To reduce dental care inequalities, universal access with universal dental coverage should be considered. Electronic supplementary material The online version of this article (10.1186/s12903-019-0881-7) contains supplementary material, which is available to authorized users.

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“…Neighborhood-level sociodemographic data in Canada are available at the level of forward sortation area (FSA) postal codes [ 17 ], which have been used by both diabetes and cancer researchers as a measure of neighborhood-level socioeconomic status [ 18 , 19 ]. There is some data on the mapping of dental caries according to postal codes in children [ 20 ], and the relationship between dental billing data and neighborhood-level sociodemographic variables among Canadian children has recently been explored [ 21 ]. The present study examined whether the association of neighborhood-level socioeconomic status (SES) with the cost of dental care and dental care outcomes differs between adolescents and young adults.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood-Level Inequalities in Dental Care of Adolescents and Young Adults in Southwestern Ontario

et al. 2022

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We examined whether the association of neighborhood-level socioeconomic status (SES) with the cost of dental care and dental care outcomes differs between adolescents and young adults. A total of 2915 patient records were split into two groups: adolescents (15 to 17 years of age) and young adults (18 to 24 years of age). Three dental care outcomes—routine oral evaluation (OEV-CH-A), utilization of preventive services (PRV-CH-A), and dental treatment services (TRT-CH-A)—were determined according to the Dental Quality Alliance (DQA) criteria. Associations of neighborhood SES and other sociodemographic variables with dental care outcomes and the cost of dental care were assessed using binary logistic and univariate linear regression models, respectively. Young adults had significantly lower PRV-CH-A and higher TRT-CH-A scores when compared to adolescents. We observed a significant negative association between TRT-CH-A and median household income in both adolescents and young adults. Utilization of dental treatment services was positively associated with the cost of care in both age groups, whereas utilization of preventive services was inversely associated with the cost of care in young adults, but not in adolescents. Neighborhood-level income was inversely associated with increased TRT-CH-A in both young adults and adolescents. In summary, young adults showed significantly worse preventive and treatment outcomes when compared to adolescents. Moreover, individuals from neighborhoods with a lower household income showed a significantly higher cost of dental care, yet worse treatment outcomes.

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Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping

Cited by 6 publications

References 16 publications

Caries status of first-born child is a predictor for caries experience in younger siblings

Caries status of first-born child is a predictor for caries experience in younger siblings

Does the national dental scaling policy reduce inequalities in dental scaling usage? A population-based quasi-experimental study

Neighborhood-Level Inequalities in Dental Care of Adolescents and Young Adults in Southwestern Ontario

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