Use of oral health care services in Peru: Trends of socio-economic inequalities before and after the implementation of Universal Health Assurance

Akram Hernández-Vásquez, Guido Bendezu-Quispe, Diego Azañedo, Marilina Santero

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

1 Cita (Scopus)

Resumen

BACKGROUND: Oral health inequalities are profound worldwide. Despite major improvements in oral health, inequalities exist for many racial and ethnic groups, by socioeconomic status, gender, age, and geographic location. Therefore, the purpose of this study was to investigate trends of socio-economic inequalities in access to oral health services in Peru before and after the implementation of Universal Health Assurance (AUS).

METHODS: Analytical cross-sectional study based on the National Household Survey on Living Conditions and Poverty (ENAHO) 2004, 2008, 2010 and 2017. Two periods were defined before and after the AUS Law (2009). Use of oral health services was the dependent variable, for the general population and according to ages, the area of residence, and natural region. Measurements of inequality in the use of health services were made based on the concentration curves (CC), dominance test and concentration index (CI).

RESULTS: We included a number of 85,436 (2004), 88,673 (2008), 87,074 (2010) and 124,142 (2017) participants. The proportion of people who used oral health services was 8.4% (2014), 10.1% (2008), 10.6% (2010) and 10.4% (2017). Use of oral health services showed an increase in different age groups, urban and rural areas, and natural regions of residence during the study period. The CC were distributed below the line of equality, indicating an inequality of use of oral health services, in favor of the richest groups and dominance of the CC in 2017 over the previous years. Changes in the CI were statistically significant for < 5 years and in the rural area, and for the period 2010-2017 they were also significant in the general population, children aged 5-17 years, urban area, and Andean and Jungle regions, which indicates a reduction in the concentration of use of these services in these groups.

CONCLUSIONS: The use of oral health services in Peru increased and inequality decreased in the period 2004-2017, coinciding with the implementation of the AUS. However, the use of these services continue having a distribution in favor of the richest populations. It requires the introduction of new strategies and oral health programs in the Peruvian population, with the aim of closing the gap currently mediated by the economic possibilities.

Idioma originalInglés estadounidense
Número de artículo39
Páginas (desde-hasta)39
PublicaciónBMC Oral Health
Volumen19
N.º1
DOI
EstadoPublicada - 7 mar 2019

Huella dactilar

Peru
Oral Health
Health care
Health Services
Economics
Health
Delivery of Health Care
Population
Geographic Locations
Social Conditions
Poverty
Ethnic Groups
Social Class
Age Groups
Cross-Sectional Studies

Citar esto

@article{125202cb56e348b085da139c2e38fc36,
title = "Use of oral health care services in Peru: Trends of socio-economic inequalities before and after the implementation of Universal Health Assurance",
abstract = "BACKGROUND: Oral health inequalities are profound worldwide. Despite major improvements in oral health, inequalities exist for many racial and ethnic groups, by socioeconomic status, gender, age, and geographic location. Therefore, the purpose of this study was to investigate trends of socio-economic inequalities in access to oral health services in Peru before and after the implementation of Universal Health Assurance (AUS).METHODS: Analytical cross-sectional study based on the National Household Survey on Living Conditions and Poverty (ENAHO) 2004, 2008, 2010 and 2017. Two periods were defined before and after the AUS Law (2009). Use of oral health services was the dependent variable, for the general population and according to ages, the area of residence, and natural region. Measurements of inequality in the use of health services were made based on the concentration curves (CC), dominance test and concentration index (CI).RESULTS: We included a number of 85,436 (2004), 88,673 (2008), 87,074 (2010) and 124,142 (2017) participants. The proportion of people who used oral health services was 8.4{\%} (2014), 10.1{\%} (2008), 10.6{\%} (2010) and 10.4{\%} (2017). Use of oral health services showed an increase in different age groups, urban and rural areas, and natural regions of residence during the study period. The CC were distributed below the line of equality, indicating an inequality of use of oral health services, in favor of the richest groups and dominance of the CC in 2017 over the previous years. Changes in the CI were statistically significant for < 5 years and in the rural area, and for the period 2010-2017 they were also significant in the general population, children aged 5-17 years, urban area, and Andean and Jungle regions, which indicates a reduction in the concentration of use of these services in these groups.CONCLUSIONS: The use of oral health services in Peru increased and inequality decreased in the period 2004-2017, coinciding with the implementation of the AUS. However, the use of these services continue having a distribution in favor of the richest populations. It requires the introduction of new strategies and oral health programs in the Peruvian population, with the aim of closing the gap currently mediated by the economic possibilities.",
keywords = "Cross-Sectional Studies, Health services misuse, Healthcare disparities, Oral health, Peru (source: MeSH NLM), Surveys and Questionnaires",
author = "Akram Hern{\'a}ndez-V{\'a}squez and Guido Bendezu-Quispe and Diego Aza{\~n}edo and Marilina Santero",
year = "2019",
month = "3",
day = "7",
doi = "10.1186/s12903-019-0731-7",
language = "American English",
volume = "19",
pages = "39",
journal = "BMC Oral Health",
issn = "1472-6831",
publisher = "Springer Verlag",
number = "1",

}

Use of oral health care services in Peru: Trends of socio-economic inequalities before and after the implementation of Universal Health Assurance. / Hernández-Vásquez, Akram; Bendezu-Quispe, Guido; Azañedo, Diego; Santero, Marilina.

En: BMC Oral Health, Vol. 19, N.º 1, 39, 07.03.2019, p. 39.

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

TY - JOUR

T1 - Use of oral health care services in Peru: Trends of socio-economic inequalities before and after the implementation of Universal Health Assurance

AU - Hernández-Vásquez, Akram

AU - Bendezu-Quispe, Guido

AU - Azañedo, Diego

AU - Santero, Marilina

PY - 2019/3/7

Y1 - 2019/3/7

N2 - BACKGROUND: Oral health inequalities are profound worldwide. Despite major improvements in oral health, inequalities exist for many racial and ethnic groups, by socioeconomic status, gender, age, and geographic location. Therefore, the purpose of this study was to investigate trends of socio-economic inequalities in access to oral health services in Peru before and after the implementation of Universal Health Assurance (AUS).METHODS: Analytical cross-sectional study based on the National Household Survey on Living Conditions and Poverty (ENAHO) 2004, 2008, 2010 and 2017. Two periods were defined before and after the AUS Law (2009). Use of oral health services was the dependent variable, for the general population and according to ages, the area of residence, and natural region. Measurements of inequality in the use of health services were made based on the concentration curves (CC), dominance test and concentration index (CI).RESULTS: We included a number of 85,436 (2004), 88,673 (2008), 87,074 (2010) and 124,142 (2017) participants. The proportion of people who used oral health services was 8.4% (2014), 10.1% (2008), 10.6% (2010) and 10.4% (2017). Use of oral health services showed an increase in different age groups, urban and rural areas, and natural regions of residence during the study period. The CC were distributed below the line of equality, indicating an inequality of use of oral health services, in favor of the richest groups and dominance of the CC in 2017 over the previous years. Changes in the CI were statistically significant for < 5 years and in the rural area, and for the period 2010-2017 they were also significant in the general population, children aged 5-17 years, urban area, and Andean and Jungle regions, which indicates a reduction in the concentration of use of these services in these groups.CONCLUSIONS: The use of oral health services in Peru increased and inequality decreased in the period 2004-2017, coinciding with the implementation of the AUS. However, the use of these services continue having a distribution in favor of the richest populations. It requires the introduction of new strategies and oral health programs in the Peruvian population, with the aim of closing the gap currently mediated by the economic possibilities.

AB - BACKGROUND: Oral health inequalities are profound worldwide. Despite major improvements in oral health, inequalities exist for many racial and ethnic groups, by socioeconomic status, gender, age, and geographic location. Therefore, the purpose of this study was to investigate trends of socio-economic inequalities in access to oral health services in Peru before and after the implementation of Universal Health Assurance (AUS).METHODS: Analytical cross-sectional study based on the National Household Survey on Living Conditions and Poverty (ENAHO) 2004, 2008, 2010 and 2017. Two periods were defined before and after the AUS Law (2009). Use of oral health services was the dependent variable, for the general population and according to ages, the area of residence, and natural region. Measurements of inequality in the use of health services were made based on the concentration curves (CC), dominance test and concentration index (CI).RESULTS: We included a number of 85,436 (2004), 88,673 (2008), 87,074 (2010) and 124,142 (2017) participants. The proportion of people who used oral health services was 8.4% (2014), 10.1% (2008), 10.6% (2010) and 10.4% (2017). Use of oral health services showed an increase in different age groups, urban and rural areas, and natural regions of residence during the study period. The CC were distributed below the line of equality, indicating an inequality of use of oral health services, in favor of the richest groups and dominance of the CC in 2017 over the previous years. Changes in the CI were statistically significant for < 5 years and in the rural area, and for the period 2010-2017 they were also significant in the general population, children aged 5-17 years, urban area, and Andean and Jungle regions, which indicates a reduction in the concentration of use of these services in these groups.CONCLUSIONS: The use of oral health services in Peru increased and inequality decreased in the period 2004-2017, coinciding with the implementation of the AUS. However, the use of these services continue having a distribution in favor of the richest populations. It requires the introduction of new strategies and oral health programs in the Peruvian population, with the aim of closing the gap currently mediated by the economic possibilities.

KW - Cross-Sectional Studies

KW - Health services misuse

KW - Healthcare disparities

KW - Oral health

KW - Peru (source: MeSH NLM)

KW - Surveys and Questionnaires

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U2 - 10.1186/s12903-019-0731-7

DO - 10.1186/s12903-019-0731-7

M3 - Article

VL - 19

SP - 39

JO - BMC Oral Health

JF - BMC Oral Health

SN - 1472-6831

IS - 1

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