Experience of socioeconomic-related inequality in dental care utilization among Thai elderly under universal coverage.
OBJECTIVE
To assess the socioeconomic-related inequality in dental care utilization among Thai elderly and to determine factors associated with the observed inequality after the country achieved universal coverage.


METHODS
The data were taken from the nationally representative Thailand Health & Welfare Survey 2007. Data of 10,096 Thai elderly (aged over 60 years) were selected. Descriptive analyses of the features of dental care utilization among Thai elderly were carried out, in addition to the concentration index (Cindex ) being used to quantify the extent of socioeconomic-related inequality in dental care utilization. Logistic regression was used to determine factors associated with inequality in dental care.


RESULTS
Socioeconomic-related inequality in dental care utilization among Thai elderly was shown. Also, utilization was more concentrated among wealthier older adults, as shown by the positive value of Cindex (equals 0.244). The poor elderly, however, were more likely to utilize dental care at public facilities, particularly primary care facilities. Multivariate analysis showed that certain demographic, socioeconomic and geographic characteristics were particularly associated with poor-rich differences in dental care utilization among Thai elderly.


CONCLUSIONS
Although socioeconomic-related inequality in dental care utilization among Thai elderly exists, the pro-poor utilization at public facilities, particularly primary care facilities, substantiates the concerted effort to reducing inequality in dental care utilization for Thai elderly.
Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. tewarit.s@chula.ac.th
Tewarit
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Somkotra
D000368:Aged; D000369:Aged, 80 and over; D003151:Community Health Centers / Q000706:statistics & numerical data; D003729:Dental Care / Q000145:classification / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009826:Old Age Assistance / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D012923:Social Class; D013785:Thailand; D019472:Universal Health Insurance; D014505:Urban Population / Q000706:statistics & numerical data