Effectiveness of protective measures on dental care utilization: analysis from linked database

Abstract Background Financial accessibility to healthcare is a cornerstone in the Belgian health care system. A whole range of financial protectives measures are applied to ensure accessibility to all residents by minimizing the medical costs including a higher reimbursement for vulnerable population groups and protective measures for people with high health expenses due to chronic diseases. This study examines the effectiveness of such protective measures on the use of dental care among a representative sample of Belgian adults. Methods Data from the participants of the Belgian health interview survey (BHIS) 2013 aged 18 years and over were individually linked with data from the Belgian compulsory health insurance data (BCHI), (n = 8,668). Multivariate logistic regression was applied to assess the impact of the financial measures on the use of dental care. Results Five percent of the population reported having delayed dental care in the past 12 months due to financial barriers. Results from the multivariate model show that irrespective of gender, age, and educational level, individuals who have preferential reimbursement are more likely to postpone their dental care (OR = 3.32, 95% CI: 1.87-5.92), while those who can account on measures for high health expenses due to chronic diseases are less likely to do so (but not significantly). Conclusions Findings suggest that vulnerable people have more postponement despite the fact that they have a preferential reimbursement and, high expenses as a result of chronic diseases are not associated with more postponement of dental care. More targeted financial interventions should be necessary to reduce postponement of dental service utilization. Key messages Current health interventions are not yet effective for vulnerable people in dental care use. High expenses as a result of chronic diseases are not associated with more postponement of dental care.