Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

International Journal of Environmental Research and Public Health

Marco Cornejo-Ovalle⁴  Guillermo Paraje²  Felipe Vásquez-Lavín¹  Glòria Pérez³  Laia Palència³  Carme Borrell³ 

[1] School of Economics and Business, Universidad del Desarrollo, 456 Ainavillo, Concepción 4030000, Chile; E-Mail:;Business School, Adolfo Ibañez University, 12138 Av. Las Torres , Santiago de Chile 7910000, Chile; E-Mail:;Service of Health Information Systems, Public Health Agency of Barcelona (ASPB), Barcelona 08023, Spain; E-Mails:;Faculty of Dentistry, University of Chile, 943 Sergio Livingstone Pohlhammer, Independencia, Santiago de Chile 8380000, Chile

关键词: utilization;    access;    oral health care;    insurance;    health guarantee;    social inequalities;    Chile;   

DOI  :  10.3390/ijerph120302823

来源: mdpi

【 摘 要 】

The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20–39, 40–59, 60–63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (C_Index) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The C_Index for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.