Reports 2013/07

Unmet needs for dental services

International comparisons and analyzes of social and regional inequalities in Norway

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There are several reasons why unmet need of dental care should be looked into. One of the reasons is that dentist consultations in Norway require a high degree of patient’s payment, another that there are data sources that make it possible to analyze the situation at the national level (the level of living survey in Norway) and compare the unmet needs at the international level (the European Union Survey of Income and Living Conditions (EU-SILC)). The international comparison of the unmet need is highlighted through a combination of data sources and methodology. In addition to the use of EU-SILC data there has among other things been a meeting with The National Board of Health and Welfare in Sweden and a questionnaire mapping out characteristics of the dental care systems in Nordic countries is sent to Denmark, Finland, Iceland and Sweden. At the national level logistic regression models are used to identify and analyze statistical correlation between social and regional factors at the one hand and the unmet need for dental services at the other. The analyses are based on data from KOSTRA (Municipality-State-Reporting) and the level of living survey.

The organization and financing of dental care in the Nordic countries have both similarities and differences. All the countries have relatively decentralized systems and responsibilities for providing the services. At the same time the division of labor between public and private sector, the financing of the services and the coverage of dentists in the countries differ. This information is included because there is reason to believe that structural characteristics could influence the unmet need for dental services. There are quite big differences in unmet needs between European countries but the level has been decreasing in most countries the last 5-8 years. Among the Nordic countries Iceland is the only one with a higher percentage of unmet need than Norway. The tendency that economy is the main reason why people with unmet needs don’t consult a dentist is almost unambiguous throughout Europe. Furthermore the unmet needs are significantly bigger among those with low levels of education and income than high, and when unemployed and employed persons are compared the latter has a lower percentage of unmet need.

Results from the analysis at the national level show that there are a few factors that influence the likelihood of having unmet need of a dentist consultation. To be a social security and welfare beneficiary and to be part of a household with low income are two socioeconomic factors in the logistic regression model that increase the likelihood of having unmet needs, while to be a resident of Northern Norway is the only regional factor in the model that increases the likelihood. Furthermore, to be a social security and welfare beneficiary and to be part of a household with low income also increase the likelihood of having unmet needs because of economic reasons. The same is the case when it comes to being a resident of Northern Norway and being a resident of a county with high coverage in dentists.

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