Abstract
BACKGROUND: The influence of the coronavirus disease 2019 (COVID-19) pandemic on dental care utilization may have differed according to individual characteristics or type of dental care provision. This study aimed to evaluate the changes in dental care utilization and per-attendance costs by age group and type of dental care during the COVID-19 pandemic in Japan. METHODS: This time-series study used healthcare insurance claims data from 01/07/2019 to 09/27/2021 (143 weeks) from nine municipalities in Japan. Dental care utilization rate per week and average dental care cost per attendance by age groups (0-19 years/20-64 years/65-74 years/≥75 years) and types of dental care (outpatient/visiting) were used as outcome variables. COVID-19 pandemic waves in Japan were used as predictors: 1(st) (03/23/2020-05/17/2020), 2(nd) (06/22/2020-09/27/2020), 3(rd) (10/26/2020-02/21/2021), 4(th) (02/22/2021-06/07/2021), and 5(th) (07/05/2021-09/13/2021) waves. Fixed-effects models were employed to estimate the proportional changes. RESULTS: In the fixed-effects model, we observed large declines in dental care utilization during the 1(st) (17.0-22.0%) and 2(nd) waves (3.0-13.0%) compared to the non-pandemic wave period in all age groups. In contrast, the average dental care cost per attendance increased in all age groups by 5.2-8.6% during the 1(st) wave. CONCLUSION: During the initial wave of the COVID-19 pandemic in Japan, dental care utilization decreased in all age groups, whereas the average dental care cost per attendance increased. The COVID-19 pandemic may have changed the dental care provision pattern towards less frequent and more concentrated dental care to avoid the risk of infection.