title: Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons.
abstract: OBJECTIVE
  The increasing medical expenses of elderly persons in Japan's rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date.
  
  
  METHODS
  Participants were 259 elderly subjects (range: 65-84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses ('Good', 'Not good' and 'Not at all good') on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman's rank method, the Mann-Whitney U-test and the Kruskal-Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables.
  
  
  RESULTS
  A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees.
  
  
  CONCLUSIONS
  The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.
authors.affiliation: Division of Oral Health Science, Department of Geriatric Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita-ku, Sapporo, Japan. eririn1953214@mb.infoweb.ne.jp
authors.forename: Eriko
authors.initials: E
authors.lastname: Harada
authors.forename: Shingo
authors.initials: S
authors.lastname: Moriya
authors.forename: Ayumi
authors.initials: A
authors.lastname: Murata
authors.forename: Masumi
authors.initials: M
authors.lastname: Muramatsu
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kashiwazaki
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Notani
authors.forename: Nobuo
authors.initials: N
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D002908:Chronic Disease; D004522:Educational Status; D004651:Employment; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006304:Health Status; D006801:Humans; D057187:Independent Living; D007398:Interpersonal Relations; D007564:Japan; D008297:Male; D009909:Oral Health; D010512:Periodontal Index; D012111:Residence Characteristics; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000145:classification