Dental service use among patients with specific disabilities: A nationwide population-based study.
OBJECTIVE
The Taiwan National Health Insurance program has allocated a specific fund for dental services to patients with specific disabilities (PSDs); however, the trends and the quality are unknown. In this study, we conducted quantity analyses and quality assessments of dental service use among PSDs using a nationwide population-based database.


METHODS
PSDs were identified according to the codes of diagnosis fee. Quantity analyses included the number of patients receiving dental services, the number of visits, and the percentages of categories of dental service use. Quality assessments included refilling rates for operative dental treatments and unfinished rates for endodontic therapies.


RESULTS
For quantity analyses, dental services were accessible to 3-4% of patients with disabilities and were mostly provided to younger PSDs. The general population received more operative and endodontic therapies, and PSDs received more periodontal therapies. For quality assessments, the teeth of PSDs had a 9.74-15.07% refilling rate, which was higher than that of the general population (1.39-6.37%). Furthermore, the teeth of PSDs had a 32.03% unfinished endodontic rate, which was higher than that of the general population (21.42%).


CONCLUSIONS
During 2010-2012, only 3-4% of patients with disabilities had access to dental services, mostly provided to younger PSDs. Teeth of PSDs had higher refilling rates and unfinished endodontic sessions than the general population. We suggest that a more comprehensive dental care system is necessary to improve the quantity and quality of dental services, especially in middle-aged and older PSDs.
Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan; Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Po-Yen
PY
Lin
A+ Inc. Headquarters, Taipei, Taiwan.
Kuang-Wen
KW
Wang
Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Yu-Kang
YK
Tu
Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Hsin-Ming
HM
Chen
Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan. Electronic address: chily@ym.edu.tw.
Lin-Yang
LY
Chi
Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan. Electronic address: pinlin@ntu.edu.tw.
Chun-Pin
CP
Lin
D016208:Databases, Factual; D003729:Dental Care / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D009313:National Health Programs; D013624:Taiwan
Taiwan National Health Insurance Database; dental service; disability; quality assessment