Abstract
OBJECTIVES: With the growing emphasis on incorporating dental care into universal health coverage (UHC) worldwide, it is essential to understand the extent to which UHC can improve access to needed health services without financial hardship. Dental care services should be included in monitoring progress toward UHC, but are often left out, even in countries with UHC. This study will compare socioeconomics-related inequalities in dental care utilization among older Australians and Japanese, who experience contrasting universal dental insurance systems. METHODS: We used data from Australia and Japan to estimate socioeconomics-related inequalities in dental care utilization as the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) for community-dwelling adults aged 65 years and older. Socioeconomic status was measured using equivalized income and educational attainment. Dental care utilization was defined as visiting a dentist within the past 12 months. RESULTS: The study included 6104 Australian participants (mean age 73.8 years) and 19,043 Japanese participants (mean age 74.9 years). Income-related inequalities in dental care utilization were higher in Australia [SII (0.22, 95% CI = 0.18-0.27); RII (1.48, 95% CI = 1.36-1.59)] than in Japan [SII (0.16, 95% CI = 0.14-0.19); RII (1.28, 95% CI = 1.24-1.33)]. We found a similar pattern in educational attainment. CONCLUSIONS: Notwithstanding the differences between the two dental care systems, the lack of UHC in dental care in Australia may be a contributing factor to greater inequalities in dental care utilization among older adults.