[Lack of medical or dental care: Impact on health expenditures for people with chronic disease]

Rev Epidemiol Sante Publique. 2020 Apr;68(2):91-98. doi: 10.1016/j.respe.2019.12.002. Epub 2020 Feb 20.
[Article in French]

Abstract

Background: People with chronic disease often have dental (especially periodontal) disorders. Nevertheless, people with chronic disease seek dental care less often than others. We wanted to know if there is a relationship between the consumption of medical care and the consumption of dental care, and if so if the relationship is especially strong for people with chronic disease.

Methods: We conducted a longitudinal study that combined two data-sets: consumption data from the French National Health Insurance Fund and health and socioeconomic welfare data collected with a dedicated national survey. We studied healthcare expenditure and analyzed the association between healthcare consumption, health status and healthcare expenditure over a four-year period (2010-2013).

Results: People who did not seek medical or dental care in 2010 exhibited irregular consumer behavior thereafter. This pattern was particularly evident among those with chronic disease whose healthcare expenditures did not stabilize during the study period compared with the rest of the study population. Among people who did not seek medical care in 2010, variation in average dental care expenditure was 91% in people with chronic disease versus 42% for those without chronic disease. Lack of medical care during the first year of the study was also associated with greater expenditure-delay in people with chronic disease (77%) compared with 15% in people without chronic disease.

Conclusion: The lack of medical or dental care in 2010 for people with chronic disease did not lead to an increase in medical and dental consumption in the following years. The catch-up delay was longer than four years. This highlights a problem of monitoring and identifies a marginalized population within the healthcare system.

Keywords: Chronic disease; Dental health; Dépenses de santé; Economics; Health expenditure; Pathologie chronique; Recours aux soins; Recourse of care; Santé dentaire; Économie.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease* / economics
  • Chronic Disease* / epidemiology
  • Chronic Disease* / therapy
  • Datasets as Topic / statistics & numerical data
  • Dental Care / economics*
  • Dental Care / standards
  • Dental Care / statistics & numerical data
  • Female
  • France / epidemiology
  • Health Expenditures* / statistics & numerical data
  • Health Services Accessibility / economics*
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data
  • Health Status
  • Health Status Disparities
  • Healthcare Disparities / economics*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mouth Diseases / economics
  • Mouth Diseases / epidemiology
  • National Health Programs / economics
  • National Health Programs / statistics & numerical data
  • Oral Health / economics
  • Oral Health / standards
  • Oral Health / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Young Adult