Inequity in oral health care for elderly canadians: part 2. Causes and ethical considerations (original) (raw)
Related papers
Canadian Opinions on Publicly Financed Dental Care
Canadian Journal of Public Health, 2007
Background: Inequalities in oral health and care are long recognized in Canada, with public health environments increasingly focusing on issues of equity and access to care. How does Canada publicly insure for diseases that are largely preventable, minimally experienced by the majority, but that still cause tremendous suffering among the socially marginalized? We consider this dynamic by asking Canadians their opinions on publicly financed dental care. Methods: Data were collected from 1,006 Canadian adults through a telephone interview survey using random digit dialling and computer-assisted telephone interview technology. Simple descriptive and bivariate analyses were undertaken to assess relationships among variables, with logistic regression odds ratios calculated for significant relations. Results: Canadians support the idea of universal coverage for dental care, also recognizing the need for care to specific groups. Generally preferring to access public care through the private sector, Canadians support the idea of opting out, and expect those who access such care to financially contribute at point of service. Conclusion: Support for publicly financed dental care is indicative of a general support for a basic right to health care. Within the limits of economy, the distribution of oral disease, and Canadian values on health, the challenge remains to define what we think is equitable within this sector of the health care system. This question is ultimately unanswerable through any survey or statistical means, and must, to become relevant, be openly promoted and debated in the social arena, engaging Canadians and their sense of individual and social responsibility. MeSH terms: Dental care delivery; public opinion; access to health care; policy La traduction du résumé se trouve à la fin de l'article.
Dental insurance, income and the use of dental care in Canada
Journal (Canadian Dental Association), 2007
Using recent Canadian health survey data, we investigated the effect of socioeconomic status on patients' use of dental services and dental insurance coverage. Our results point to an important socioeconomic gradient in the use of dental services. The probability of receiving any dental care over the course of a year increases markedly with dental insurance, household income, and level of education. Among those receiving at least some dental care, however, a person's general oral health--not financial factors--largely determined visit frequency. The insurance effect appears to operate through a reduction in price paid at point of service, not decisions by those with high anticipated need for dental care to selectively purchase insurance. Indeed, those with poorer self-assessed oral health, as well as those from Quebec (where dental benefits are subject to personal income tax) and those over 65 years of age (who have likely lost employer provided coverage) were less likely to...
Grootendorst P: Dental insurance, income and the use of dental care in Canada
2020
Using recent Canadian health survey data, we investigate the effect of individuals' socio-economic status on their use of dental services and dental insurance coverage. Our results point to an important socio-economic gradient in the use of dental services. The probability of receiving any dental care over the course of a year increases markedly with dental insurance, household income, and ones level of educational attainment. Conditional on receiving some dental care, however, ones general oral health -not financial factors -largely determines visit frequency. The insurance effect appears to operate through a reduction in price paid at point of service, not the decision of those with high anticipated need for dental care to selectively purchase insurance. Indeed, those with poorer self assessed oral health, as well as those from Quebec (where dental benefits are subject to personal income tax), and those 65+ (who have likely lost employer-provided coverage) are less likely to ...
Equity in dental care among Canadian households
International Journal for Equity in Health, 2011
Background: Changes in third party financing, whether public or private, are linked to a household's ability to access dental care. By removing costs at point of purchase, changes in financing influence the need to reach into one's pocket, thus facilitating or limiting access. This study asks: How have historical changes in dental care financing influenced household out-of-pocket expenditures for dental care in Canada? Methods: This is a mixed methods study, comprised of an historical review of Canada's dental care market and an econometric analysis of household out-of-pocket expenditures for dental care. Results: We demonstrate that changes in financing have important implications for out-of-pocket expenditures: with more financing come drops in the amount a household has to spend, and with less financing come increases. Low-and middle-income households appear to be most sensitive to changes in financing. Conclusions: Alleviating the price barrier to care is a fundamental part of improving equity in dental care in Canada. How people have historically spent money on dental care highlights important gaps in Canadian dental care policy.
Canadian Dentists' Opinions on Publicly Financed Dental Care
Journal of Public Health Dentistry, 2009
Objective: The aim of this study was to inform policy leaders of the opinions of Canada's major dental care service provider regarding publicly financed dental care. Methods: Using provincial/territorial dental regulatory authority listings, a 26-item questionnaire was sent to a representative sample of Canadian dentists (n = 2219, response rate = 45.8 percent). Descriptive statistics were produced, and bivariate and multivariate logistic regressions were conducted to assess what predicts dentists' responses. Results: Canadian dentists support governmental involvement in dental care, preferring investments in prevention to direct delivery. The majority of dentists have less than 10 percent of their practice represented by publicly insured patients, with a small minority having greater than 50 percent. The majority would accept new publicly insured patients, preferring fee for service remuneration. Dentists generally appear dissatisfied with public forms of third-party financing. Conclusions: Dentists prefer a targeted effort at meeting public needs and are influenced in their opinions largely in relation to ideology. In order to move forward, policy leaders will need to devote some attention to the influence and complexity of public and private tensions in dentistry. At the very least, public and private practitioners must come to appreciate each other's challenges and balance public and private expectations in public programming.
Toward a Universal Dental Care Plan: Policy Options for Canada
IRPP INSIGHT No. 46, 2023
Canada is a laggard when it comes to providing public funding for dental care, ranking close to the bottom of OECD countries. However, the federal government's proposed $13-billion Canadian Dental Care Plan could change that. This paper calls the plan a major step forward in reforming dental care but argues that the "payer of last resort model" the government has chosen to implement falls short. It identifies four broad policy goals that should guide future reform of dental care and six possible options for achieving them. It calls for the government to move toward implementing universal dental care coverage for a limited core of essential dental services and argues that the best way to achieve it is through the creation of a federally funded arm's-length agency.
Community Dentistry and Oral Epidemiology, 2010
Quiñonez C, Figueiredo R, Azarpazhooh A, Locker D. Public preferences for seeking publicly financed dental care and professional preferences for structuring it. Community Dent Oral Epidemiol 2010. © 2010 John Wiley & Sons A/SAbstract – Objectives: To test the hypotheses that socially marginalised Canadians are more likely to prefer seeking dental care in a public rather than private setting, and that Canadian dentists are more likely to prefer public dental care plans that approximate private insurance processes.Methods: Data on public opinion were collected through a weekly national omnibus survey based on random digit dialling and telephone interview technology (n = 1005, >18 years). Data on professional opinion were collected through a national mail-out survey of a random selection of Canadian dentists (n = 2219, response rate = 45.8%). Dental and socio-demographic data were collected for the public, as were professional demographic data for dentists. Descriptive and basic regression analyses were undertaken.Results: The majority of Canadians surveyed, 66.4%, prefer to seek dental care in a private setting, 19% in a community clinic, and 7.6% in a dental school; those that are younger and of lowest incomes are most likely to prefer seeking dental care in a public setting. Most Canadian dentists, 80.9%, believe that governments should be involved in dental care, yet only 46% believe this role should include direct delivery. A third of dentists have also reduced the amount of publicly insured patients in their practice. Canadian dentists are more likely to prefer those public plans that most closely reflect private insurance mechanisms.Conclusion: There appears to be a policy disconnect between the preferences of those populations where governmental involvement is most warranted, and the current mechanisms for financing and delivering dental care in Canada. By concentrating almost exclusively on third-party-type financing and indirect delivery, public dental care policy may not be adequately responding to those most in need, especially in an environment where dentists are largely dissatisfied with public plans.
2014
Access to dental care for all population groups in Canada is inequitable. While the overall dental health of Canadians is very good, there are disparities that primarily affect the financially disadvantaged in society. Current methods for delivering dental care demonstrate an economic gradient favoring more affluent members of society. An examination of the methods for financing dental care, both public and private, will be conducted to better understand the challenges to solving this dilemma. The role of government and dental professionals in providing access to dental care will be explored. The existing gaps in dental care delivery will be illustrated, and the current methods for providing dental care in northern British Columbia will be identified. While continued government support for disadvantaged groups is necessary, an investigation of alternative models of low-cost dental care delivery will be undertaken to determine the feasibility of these models in Prince George, British...