Socio-economic disparities in dental health and dental care utilisation among older Chinese

Introduction Dental care is mostly excluded from healthcare coverage in China. This study examines disparities in dental care and in the costs of such care, according to insurance type and socio-economic status, among Chinese older adults. Methods The data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A final sample of 5,230 respondents was included, with a mean age of 72 years. Edentulousness, any dental visit and per-patient dental care expenditure were used as outcome variables. Both unweighted and weighted logistic regression analyses were used to examine the association of socio-economic status (education, insurance type and income) associated with edentulousness and use of dental care. Results We found that 28% of Chinese older adults have no remaining teeth and that only 19% had used dental care in the past year. The uninsured and those with rural resident insurance had edentulousness rates of 31%, while the edentulousness rate in those with urban employee insurance was 19%. About 13% of the uninsured study respondents and 15% of those with rural resident insurance had used dental care compared with 30% of those with urban employee insurance. Those in the highest income and education groups and those enrolled in a plan with a lower coinsurance rate had a higher likelihood of using dental care services and spending more on dental care than did those in the lowest socio-economic groups. Conclusions Dental care disparities in China may be reduced through increasing the proportion of the population with insurance and expanding the range of dental treatments covered by all three major insurance schemes.