Trends of household income and dental care spending

Abstract

Objectives: This empirical study aimed to identify the differences in expenditures by household incomelevel, 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 calculatedexpenditures by service items by itemizing dental care services such as conservative, prosthetic,orthodontic, periodontal, surgical, preventive, dental implant care. Then we obtained the ratios ofspending per item and per visit to overall out-of-pocket spending on dental care and used these as theweights for dental care cost allocation. Income quintiles were derived using the equivalence scale. Kakwani’sconcentration 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 firstincome quintile was 3.6 times lower than that of the fifth income quintile. In terms of expenditure comparisonbetween 2008 and 2010, the first quintile households showed an increased spending on prostheticand periodontal treatments, whereas the fifth quintile households spent a relatively high proportionon orthodontic and dental implant care. The concentration index revealed that conservative servicesand root canal treatments was significant and positive, indicating that the demand for, and utilizationof, these services increase as household income increases. In contrast, prosthetic services showed asignificant negative trend, indicating that these services are not as common among those with higherincomes.Conclusions: To address the problems associated with the disparity in dental care expenditures basedon income levels, it is necessary to establish policies that expand health insurance coverage and provideother supportive measures for low-income populations.