Associations between social determinants and prosthesis obtained in Bangkok elders: 10 years after universal coverage policy implementation

Abstract

In these ten years, the number of elderly populations in Bangkok has increased every year and tooth loss is still a major oral problem in their daily life. The main treatment in solving this problem is to replace the edentulous ridge with a prosthesis. There are many factors that affect the elderly to obtain the prosthesis. For the financial aspect, the government has supported the elderly by three main supporting insurance systems. The aim of this study is to investigate the associations between social determinants and prosthesis obtained of the elderly in Bangkok, during 10 years after the implementation of the universal coverage policy. We analyzed data from two main surveys: the survey of the older persons in Thailand (2007, 2014, and 2017) and the Thai National Oral Health Survey (2007, 2012, and 2017). This study is a retrospective cross-sectional study that uses data from the 5th survey of the older persons in Thailand (2014) to analyze by using logistic regression model to analyze the association between prosthesis obtained and social determinant. The result showed that even the elderly in Bangkok got dental insurance to obtain prosthesis nevertheless, only less than half of the elderly got a prosthesis. There are many factors related to the prosthesis obtained. Not only the elderly characteristics, but social/community factors and government support have also associated with the prosthesis obtained. One of the important factors is a big gap between the price of the insurance coverage and the actual fee. Besides oral health insurance, another factor that affects the access is the person whom elderly is living with and receiving the information from.