Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study

BMC Oral Health

Hans Wolff¹  Jean-Michel Gaspoz³  Patrick Bodenmann²  Silvia Stringhini⁴  Claire Durosier Izart³  Jean-Marc Theler³  Idris Guessous⁵ 

[1] Division of Penitentiary Medicine and Psychiatry, Department of Community Medicine, Primary Care, and Emergency Medicine, University Hospital Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland;Vulnerable Population Unit, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland;Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland;Community Prevention Unit, University Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland;Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland

关键词: Insurance;    Socioeconomic status;    Forgoing;    Dental care;   

Others  :  1091669
DOI  :  10.1186/1472-6831-14-121

 received in 2014-06-23, accepted in 2014-09-25,  发布年份 2014

【 摘 要 】

Background

While oral health is part of general health and well-being, oral health disparities nevertheless persist. Potential mechanisms include socioeconomic factors that may influence access to dental care in the absence of universal dental care insurance coverage. We investigated the evolution, prevalence and determinants (including socioeconomic) of forgoing of dental care for economic reasons in a Swiss region, over the course of six years.

Methods

Repeated population-based surveys (2007–2012) of a representative sample of the adult population of the Canton of Geneva, Switzerland. Forgone dental care, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods.

Results

A total of 4313 subjects were included, 10.6% (457/4313) of whom reported having forgone dental care for economic reasons in the previous 12 months. The crude percentage varied from 2.4% in the wealthiest group (monthly income ≥13,000CHF, 1CHF ≈ 1$) to 23.5% among participants with the lowest income (<3,000CHF). Since 2007/8, forgoing dental care remained stable overall, but in subjects with a monthly income of <3,000CHF, the adjusted percentage increased from 16.3% in 2007/8 to 20.6% in 2012 (P trend = 0.002). Forgoing dental care for economic reasons was independently associated with lower income, younger age, female gender, current smoking, having dependent children, divorced status and not living with a partner, not having a supplementary health insurance, and receipt of a health insurance premium cost-subsidy.

Conclusions

In a Swiss region without universal dental care insurance coverage, prevalence of forgoing dental care for economic reasons was high and highly dependent on income. Efforts should be made to prevent high-risk populations from forgoing dental care.

【 授权许可】

   
2014 Guessous et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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