J Korean Acad Oral Health.  2014 Mar;38(1):17-24.

Trends of household income and dental care spending

Affiliations
  • 1Apple Tree Dental Hospital, Ilsan, Korea.
  • 2Department of Humanity and Social Dentistry, Wonkwang University College of Dentistry, Iksan, Korea. shinhosung@gmail.com

Abstract

OBJECTIVES: This empirical study aimed to identify the differences in expenditures by household income level, as well as the patterns of dental care spending by dental services.
METHODS
We analyzed the Korea Health Panel's data collected between 2008 and 2010. We calculated expenditures by service items by itemizing dental care services such as conservative, prosthetic, orthodontic, periodontal, surgical, preventive, dental implant care. Then we obtained the ratios of spending per item and per visit to overall out-of-pocket spending on dental care and used these as the weights for dental care cost allocation. Income quintiles were derived using the equivalence scale. Kakwani's concentration index was used to determine the degree of disparity by income quintile, and 95% confidence intervals were computed.
RESULTS
Out-of-pocket expenditures on dental care steadily increased over time and income quintile. The analysis of dental care spending by income quintile revealed that the level of expenditure of the first income quintile was 3.6 times lower than that of the fifth income quintile. In terms of expenditure comparison between 2008 and 2010, the first quintile households showed an increased spending on prosthetic and periodontal treatments, whereas the fifth quintile households spent a relatively high proportion on orthodontic and dental implant care. The concentration index revealed that conservative services and root canal treatments was significant and positive, indicating that the demand for, and utilization of, these services increase as household income increases. In contrast, prosthetic services showed a significant negative trend, indicating that these services are not as common among those with higher incomes.
CONCLUSIONS
To address the problems associated with the disparity in dental care expenditures based on income levels, it is necessary to establish policies that expand health insurance coverage and provide other supportive measures for low-income populations.

Keyword

Dental care expenditures; Household income; Concentration index; Korea Health Panel
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