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Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach

BACKGROUND: Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental c...

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Autores principales: Winkelmann, Juliane, Gómez Rossi, Jesús, Schwendicke, Falk, Dimova, Antoniya, Atanasova, Elka, Habicht, Triin, Kasekamp, Kaija, Gandré, Coralie, Or, Zeynep, McAuliffe, Úna, Murauskiene, Liubove, Kroneman, Madelon, de Jong, Judith, Kowalska-Bobko, Iwona, Badora-Musiał, Katarzyna, Motyl, Sylwia, Figueiredo Augusto, Gonçalo, Pažitný, Peter, Kandilaki, Daniela, Löffler, Lubica, Lundgren, Carl, Janlöv, Nils, van Ginneken, Ewout, Panteli, Dimitra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905841/
https://www.ncbi.nlm.nih.gov/pubmed/35260137
http://dx.doi.org/10.1186/s12903-022-02095-4
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author Winkelmann, Juliane
Gómez Rossi, Jesús
Schwendicke, Falk
Dimova, Antoniya
Atanasova, Elka
Habicht, Triin
Kasekamp, Kaija
Gandré, Coralie
Or, Zeynep
McAuliffe, Úna
Murauskiene, Liubove
Kroneman, Madelon
de Jong, Judith
Kowalska-Bobko, Iwona
Badora-Musiał, Katarzyna
Motyl, Sylwia
Figueiredo Augusto, Gonçalo
Pažitný, Peter
Kandilaki, Daniela
Löffler, Lubica
Lundgren, Carl
Janlöv, Nils
van Ginneken, Ewout
Panteli, Dimitra
author_facet Winkelmann, Juliane
Gómez Rossi, Jesús
Schwendicke, Falk
Dimova, Antoniya
Atanasova, Elka
Habicht, Triin
Kasekamp, Kaija
Gandré, Coralie
Or, Zeynep
McAuliffe, Úna
Murauskiene, Liubove
Kroneman, Madelon
de Jong, Judith
Kowalska-Bobko, Iwona
Badora-Musiał, Katarzyna
Motyl, Sylwia
Figueiredo Augusto, Gonçalo
Pažitný, Peter
Kandilaki, Daniela
Löffler, Lubica
Lundgren, Carl
Janlöv, Nils
van Ginneken, Ewout
Panteli, Dimitra
author_sort Winkelmann, Juliane
collection PubMed
description BACKGROUND: Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach. METHODS: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists. RESULTS: Completed vignettes were received from 11 countries: Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different physical barriers to accessing dental care. The limited availability of contracted dentists (especially in rural areas) and the unequal distribution and lack of specialised dentists are major access barriers to public dental care. CONCLUSIONS: According to the results, statutory coverage of dental care varies across European countries, while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries, leading to high out-of-pocket spending. Socioeconomic status is thus a main determinant for access to dental care, but other factors such as geography, age and comorbidities can also inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-022-02095-4.
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spelling pubmed-89058412022-03-18 Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach Winkelmann, Juliane Gómez Rossi, Jesús Schwendicke, Falk Dimova, Antoniya Atanasova, Elka Habicht, Triin Kasekamp, Kaija Gandré, Coralie Or, Zeynep McAuliffe, Úna Murauskiene, Liubove Kroneman, Madelon de Jong, Judith Kowalska-Bobko, Iwona Badora-Musiał, Katarzyna Motyl, Sylwia Figueiredo Augusto, Gonçalo Pažitný, Peter Kandilaki, Daniela Löffler, Lubica Lundgren, Carl Janlöv, Nils van Ginneken, Ewout Panteli, Dimitra BMC Oral Health Research BACKGROUND: Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach. METHODS: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists. RESULTS: Completed vignettes were received from 11 countries: Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different physical barriers to accessing dental care. The limited availability of contracted dentists (especially in rural areas) and the unequal distribution and lack of specialised dentists are major access barriers to public dental care. CONCLUSIONS: According to the results, statutory coverage of dental care varies across European countries, while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries, leading to high out-of-pocket spending. Socioeconomic status is thus a main determinant for access to dental care, but other factors such as geography, age and comorbidities can also inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-022-02095-4. BioMed Central 2022-03-09 /pmc/articles/PMC8905841/ /pubmed/35260137 http://dx.doi.org/10.1186/s12903-022-02095-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Winkelmann, Juliane
Gómez Rossi, Jesús
Schwendicke, Falk
Dimova, Antoniya
Atanasova, Elka
Habicht, Triin
Kasekamp, Kaija
Gandré, Coralie
Or, Zeynep
McAuliffe, Úna
Murauskiene, Liubove
Kroneman, Madelon
de Jong, Judith
Kowalska-Bobko, Iwona
Badora-Musiał, Katarzyna
Motyl, Sylwia
Figueiredo Augusto, Gonçalo
Pažitný, Peter
Kandilaki, Daniela
Löffler, Lubica
Lundgren, Carl
Janlöv, Nils
van Ginneken, Ewout
Panteli, Dimitra
Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title_full Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title_fullStr Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title_full_unstemmed Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title_short Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
title_sort exploring variation of coverage and access to dental care for adults in 11 european countries: a vignette approach
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905841/
https://www.ncbi.nlm.nih.gov/pubmed/35260137
http://dx.doi.org/10.1186/s12903-022-02095-4
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