Nan Jiang, Jonas Minet Kinge, Irene Skau, Jostein Grytten
{"title":"有补贴的正畸治疗是否减少了获得治疗的不平等？挪威根据人口登记数据提供的证据。","authors":"Nan Jiang, Jonas Minet Kinge, Irene Skau, Jostein Grytten","doi":"10.1111/cdoe.12918","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>An important part of Norwegian welfare policy is to provide subsidized orthodontic treatment for children and adolescents. The objective of this policy is that dental services should be allocated according to children's need for treatment, and not according to parents' ability to pay. The probability of receiving orthodontic treatment independent of parent's household income was examined.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The study population encompassed children and adolescents aged 10–18 years in 2019 (<i>n</i> = 354 439). Information about whether they had started orthodontic treatment was obtained from the Norwegian Health Economics Administration. The key independent variable was net equalized household income. Inequalities were measured using concentration indices, which were estimated according to the severity of the malocclusion (very great need, great need, obvious need and no need). Two indices were used to measure relative inequality: the unstandardized concentration index and the partial concentration index. Absolute inequality was measured using the corrected concentration index. Relevant control variables were included in some of the analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The unstandardized indices were in the range 0.04 (very great need) to 0.05 (obvious need). For all three groups of severity, the 95% confidence intervals overlapped. The values of the partial indices were significantly lower than the values of the unstandardized indices. The partial indices were in the range 0.008 (very great need) to 0.03 (obvious need). The 95% confidence intervals for the partial indices did not overlap with the 95% confidence intervals of the unstandardized indices. For all three groups of severity, the indices that measured absolute inequality were close to zero.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>It is possible to achieve the egalitarian aim of equality in service provision by subsidizing orthodontic treatment. This is possible within a system where the cost of orthodontic treatment is reimbursed according to the criteria of need. These criteria function in such a way that patients with the greatest need for orthodontic treatment are given the highest priority.</p>\n </section>\n </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 2","pages":"232-238"},"PeriodicalIF":1.8000,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12918","citationCount":"0","resultStr":"{\"title\":\"Does subsidized orthodontic treatment reduce inequalities in access? Evidence from Norway based on population register data\",\"authors\":\"Nan Jiang, Jonas Minet Kinge, Irene Skau, Jostein Grytten\",\"doi\":\"10.1111/cdoe.12918\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>An important part of Norwegian welfare policy is to provide subsidized orthodontic treatment for children and adolescents. The objective of this policy is that dental services should be allocated according to children's need for treatment, and not according to parents' ability to pay. The probability of receiving orthodontic treatment independent of parent's household income was examined.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The study population encompassed children and adolescents aged 10–18 years in 2019 (<i>n</i> = 354 439). Information about whether they had started orthodontic treatment was obtained from the Norwegian Health Economics Administration. The key independent variable was net equalized household income. Inequalities were measured using concentration indices, which were estimated according to the severity of the malocclusion (very great need, great need, obvious need and no need). Two indices were used to measure relative inequality: the unstandardized concentration index and the partial concentration index. Absolute inequality was measured using the corrected concentration index. Relevant control variables were included in some of the analyses.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The unstandardized indices were in the range 0.04 (very great need) to 0.05 (obvious need). For all three groups of severity, the 95% confidence intervals overlapped. The values of the partial indices were significantly lower than the values of the unstandardized indices. The partial indices were in the range 0.008 (very great need) to 0.03 (obvious need). The 95% confidence intervals for the partial indices did not overlap with the 95% confidence intervals of the unstandardized indices. For all three groups of severity, the indices that measured absolute inequality were close to zero.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>It is possible to achieve the egalitarian aim of equality in service provision by subsidizing orthodontic treatment. 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Does subsidized orthodontic treatment reduce inequalities in access? Evidence from Norway based on population register data
Objective
An important part of Norwegian welfare policy is to provide subsidized orthodontic treatment for children and adolescents. The objective of this policy is that dental services should be allocated according to children's need for treatment, and not according to parents' ability to pay. The probability of receiving orthodontic treatment independent of parent's household income was examined.
Methods
The study population encompassed children and adolescents aged 10–18 years in 2019 (n = 354 439). Information about whether they had started orthodontic treatment was obtained from the Norwegian Health Economics Administration. The key independent variable was net equalized household income. Inequalities were measured using concentration indices, which were estimated according to the severity of the malocclusion (very great need, great need, obvious need and no need). Two indices were used to measure relative inequality: the unstandardized concentration index and the partial concentration index. Absolute inequality was measured using the corrected concentration index. Relevant control variables were included in some of the analyses.
Results
The unstandardized indices were in the range 0.04 (very great need) to 0.05 (obvious need). For all three groups of severity, the 95% confidence intervals overlapped. The values of the partial indices were significantly lower than the values of the unstandardized indices. The partial indices were in the range 0.008 (very great need) to 0.03 (obvious need). The 95% confidence intervals for the partial indices did not overlap with the 95% confidence intervals of the unstandardized indices. For all three groups of severity, the indices that measured absolute inequality were close to zero.
Conclusions
It is possible to achieve the egalitarian aim of equality in service provision by subsidizing orthodontic treatment. This is possible within a system where the cost of orthodontic treatment is reimbursed according to the criteria of need. These criteria function in such a way that patients with the greatest need for orthodontic treatment are given the highest priority.
期刊介绍：
The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome.
The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry.
The journal is published bimonthly.
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