High educational attainment moderates the association between dental health‐care supply and utilization in Europe

Abstract

In line with the theory of supplier-induced demand, an increased physician density often goes along with a higher utilization of medical services, including dental services. This study aimed to assess whether dentist density and self-employment are related to dental care use, and whether these relationships are moderated by patients' educational attainment. We used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from over 20,000 respondents, 50 + yr of age, in 13 countries. We conducted multilevel logistic regressions with probability and type of dental treatment on individual education, country-specific dentist density, and dentist remuneration, and their cross-level interaction. Patients with a high educational level were more likely to report a dentist visit (OR = 2.1, 95% CI: 1.912-2.305) and to receive preventive care (OR = 1.9, 95% CI: 1.697-2.043) than those with a low educational level (reference category). Cross-level interaction effects indicated that high dentist density decreases dental care utilization differences between patients with high (OR = 0.996, 95% CI: 0.993-0.999), medium (OR = 0.995, 95% CI: 0.991-0.999), and low education levels. This was also true for prevention use (OR = 0.996, 95% CI: 0.992-0.999 for patients with a high education level, and OR = 0.996, 95% CI: 0.993-1.000 for patients with a medium education level). The findings suggest that although dentist density is positively associated with dental care utilization, patients have differing susceptibilities to dental care supply.

Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis

“…This phenomenon has been described as double disadvantage in the scientific literature. Double disadvantage has also been reported in previous studies on oral epidemiology [21,22]. Oral health disparities related to racial/ethnic background among children were greater in wealthy schools than in deprived schools [21].…”

A Q‐methodology study among caregivers of people with moderate intellectual disabilities on their clients’ health care: An example in oral health

“…When they agreed to participate, a telephone conversation with one of the authors (AE/GS) was arranged to give additional information about the project and ask for participation. As both gender and education level influence attitudes about oral health care (Al‐Omiri, Barghout, Shaweesh, & Malkawi, ; Schulz, Kunst, & Brockmann, ), a total of six target groups were composed based on gender (male or female) and education level (low, medium and high).…”

Patients' self‐reported measures of oral health—A validation study on basis of oral health questions used in a large multi‐country survey for populations aged 50+

“…Dental questions as included in the surveys named above were initially confined to aspects of dental service utilisation but have more recently evolved to also include questions on oral health outcomes such as tooth count. Data derived from these oral health surveys have, until now, mostly been used in sociodemographic analyses of dental service utilisation . Promising opportunities for research and health policy planning are emerging with an increasing availability of data on oral health outcomes.…”