Utilization of Dental Care in Patients with Mental Illnesses: a Study of a National Health Insurance database

• Main Authors: Miao-Jen Lin, 林妙貞
• Other Authors: Ling-Ling Yeh
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/95126229381549033048

碩士 === 亞洲大學 === 健康產業管理學系長期照護組 === 102 === Objective: The oral health in patients with severe mental diseases is poor in general. This might be attributed to the poor dental hygiene and in part by inadequate dental utilization. There is a paucity of studies investigating dental utilization among patients with mental diseases in Taiwan. The study aims to demonstrate the rate of dental utilization, types of oral diseases and treatments as well as factors accounting for the discrepancies in this group of patients. Method: This study employed the claim dataset of National Health Insurance from National Health Research Institutes. Patients with the diagnosis of severe mental diseases (ICD-9-CM code 290, 291, 292, 293, 294, 295, 296, 296.2&296.3, 297, 298, 299) were recruited in the analysis. The study explored the rate of dental utilization, oral diseases, treatment received and medical expenses. Regression analyses were applied for determining factors contributed to dental utilization. Results: A total of 19996 cases were included and examined in the analyses. Only 40.2% of patients had ever received dental services. The main diagnoses of oral disease were dental caries ( 32.63%) and periodontal diseases (23.57 %). The predictive factors for lower dental utilization rate included: the older persons, living in country area, lower insurance fee, had ever been hospitalized for over one month and lower dentist density. The most treatment received by patients was the periodontal therapy ( 30.27%), and then followed by operative dental therapy (20.24%)and oral maxillofacial surgery ( 18.84%); only 8.9% of patients received root canal therapy. Controlling for confounding factors, patients with senile organic diseases, other organic diseases and schizophrenia had fewer chances to receive dental services than patients with bipolar disorder and major depressive disorder. Conclusions: The study demonstrated that the dental utilization was low compared with general population. Apart from accessibility of dental services, patients with mental diseases which might lead to poor cognitive function had lower chances to receive professional dental care. The staffs of psychiatric and dental services providers should pay more attention on oral health in patients with severe mental diseases and exert more effort to enhance adequate dental services.