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Choices and utilization in dental care: Public vs. private dental sectors, and the impact of a two-channel financed health care system.

https://arctichealth.org/en/permalink/ahliterature170635
Source
Eur J Health Econ. 2006 Jun;7(2):99-106
Publication Type
Article
Date
Jun-2006
Author
Lien Nguyen
Unto Häkkinen
Author Affiliation
National Research and Development Centre for Welfare and Health, Helsinki, Finland. lien.nguyen@stakes.fi
Source
Eur J Health Econ. 2006 Jun;7(2):99-106
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Choice Behavior
Cost Sharing
Dental Health Services - economics - utilization
Fees, Dental
Female
Finland
Health Services Accessibility
Health Services Research
Humans
Insurance, Dental - economics - utilization
Male
Private Sector - economics - utilization
Public Sector - economics - utilization
Socioeconomic Factors
Abstract
We examine the determinants of the utilization of dentists' services among adults entitled to age-based subsidized dental care, using data from the Finnish Health Care Survey of 1996. We apply a three-part model to investigate the care-seeking decision, the choice of a private/public dentist, and the number of visits to each chosen dentist. Seeking care is found to be determined mainly by dentist's recall and mostly deterred by the expense of private care. Insufficient public availability and recall positively affect the choice of a private dentist, whereas income and dentist density increase the number of private visits. Need and socioeconomic variables are controlled for and are also important determinants. The findings suggest that lowering copayments and user fees and increasing the public supply of dental care, accompanied by an efficient recall system, might improve access to dental care and better steer the choice between sectors.
PubMed ID
16489469 View in PubMed
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Determinants of dental service utilization among adults--the case of Finland.

https://arctichealth.org/en/permalink/ahliterature171388
Source
Health Care Manag Sci. 2005 Nov;8(4):335-45
Publication Type
Article
Date
Nov-2005
Author
Lien Nguyen
Unto Häkkinen
Gunnar Rosenqvist
Author Affiliation
Centre for Health Economics - CHESS, National Research and Development Centre for Welfare and Health (STAKES), Lintulahdenkuja 4, P.O. Box 220, FIN-00531 Helsinki, Finland. lien.nguyen@stakes.fi
Source
Health Care Manag Sci. 2005 Nov;8(4):335-45
Date
Nov-2005
Language
English
Publication Type
Article
Keywords
Adult
Dental Health Services - economics - utilization
Female
Finland
Humans
Male
Models, Econometric
Models, Theoretical
Abstract
We examine the determinants of utilization of dentists' services and especially the role of supply factors in the decision-making processes of utilization, using data from the Finnish Health Care Survey of 1996. In a two-part model, care-seeking is modeled by a bivariate probit model taking into account dentist's recall, whereas the number of positive visits to the dentist is modeled by a zero-truncated negative binomial model. Recall turns out to be a central determinant of care-seeking and is significantly related to variables like income and unemployment. Socioeconomic variables are controlled for as well and are found to be important determinants.
PubMed ID
16379416 View in PubMed
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Income-related inequality in the use of dental services in Finland.

https://arctichealth.org/en/permalink/ahliterature174749
Source
Appl Health Econ Health Policy. 2004;3(4):251-62
Publication Type
Article
Date
2004
Author
Lien Nguyen
Unto Häkkinen
Author Affiliation
National Research and Development Centre for Welfare and Health, STAKES, Helsinki, Finland. lien.nguyen@stakes.fi
Source
Appl Health Econ Health Policy. 2004;3(4):251-62
Date
2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Dental Care - economics - statistics & numerical data - utilization
Female
Finland
Health Care Surveys
Healthcare Disparities - economics - statistics & numerical data
Humans
Income - statistics & numerical data
Male
Middle Aged
Models, Econometric
Socioeconomic Factors
Young Adult
Abstract
The aim of this article is to measure and explain income-related inequalities in dentist utilisation. We apply concentration and horizontal inequity indices and the decomposition method to decompose observed inequalities into sources. The data are from the Finnish Health Care Survey of 1996. We examine three measures of utilisation: (a) the total number of visits; (b) the probability of visiting a dentist; and (c) the conditional number of positive visits for (i) visits to all dentists, (ii) those to public dentists and (iii) those to private dentists. The results for the whole sample show pro-poor inequities in all three measures of utilisation in public care, whereas in the first two measures there are pro-rich inequities nationwide and in private care. Among those entitled to age-based subsidised dental care, we find equality and equity in all three measures of utilisation nationwide. The two main factors related to pro-rich distributions of use are income and dentist's recall. To enhance equity in dental care across income groups, attention should be focused on supply factors and other incentives to encourage the poor to contact dentists more often.
PubMed ID
15901199 View in PubMed
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Should we brush twice a day? Determinants of dental health among young adults in Finland.

https://arctichealth.org/en/permalink/ahliterature162336
Source
Health Econ. 2008 Feb;17(2):267-86
Publication Type
Article
Date
Feb-2008
Author
Lien Nguyen
Unto Häkkinen
Matti Knuuttila
Marjo-Riitta Järvelin
Author Affiliation
Centre for Health Economics - CHESS, National Research and Development Centre for Welfare and Health (STAKES), Lintulahdenkuja 4, Helsinki, Finland. lien.nguyen@stakes.fi
Source
Health Econ. 2008 Feb;17(2):267-86
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Adult
Dental Caries - epidemiology - prevention & control
Female
Finland
Health Behavior
Humans
Longitudinal Ligaments
Male
Models, Econometric
Oral Health
Oral Hygiene - statistics & numerical data
Risk factors
Abstract
We explore the determinants of dental ill-health as measured by the occurrence of caries. A recursive bivariate probit model that was derived from health production and demand theory is employed to model caries, while taking account of dental care use. The data are from a follow-up questionnaire used in a longitudinal study of the Northern Finland 1966 Birth Cohort, with respondents aged 31 (n = 5020). The factors controlled for relate to family background and health behavior during their youth, current socioecononomic variables and dental health stock. The total effects on the occurrence of caries of the explanatory variables are computed. Among females, factors increasing caries are body mass index and intake of alcohol, sugar and soft drinks, and those reducing caries are birth weight and adolescent school achievement. Among males, caries is positively related to the metropolitan residence and negatively related to education and healthy diet. Smoking increases caries, whereas dental care use, regular dental attendance and brushing teeth at least twice a day decrease caries. To promote oral health, attention should focus on policies to improve dental health education and to reduce the impacts of common risk factors.
PubMed ID
17645280 View in PubMed
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