Objective: We analyze correlates of the direction and magnitude of changes in out-of-pocket (OOP) payments for dental care by older Americans over a recent 4-year period. Methods: We analyzed data from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of the direction and linear regression models of the amounts of OOP changes over survey periods. Results: Financial-based factors were more strongly associated with the direction and magnitude of changing self-payments for dental care than were health factors. Discussion: Findings suggested that dental coverage, income, and wealth and changes in these financial factors were more strongly correlated with the persistence of and changes in OOP payments for dental care over time than were health status and changes in health status. The sensitivity to dental coverage changes should be considered as insurance and retirement policy reforms are deliberated.
Department of Health and Human Services. (2000). Oral health in America: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health.
6.
Department of Health and Human Services. (2010). Medicare dental coverage overview. Baltimore, MD: Centers for Medicare & Medicaid Services. Retrieved fromhttps://www.cms.gov/MedicareDentalCoverage
7.
Institute of Medicine and National Research Council. (2011). Improving access to oral health care for vulnerable and underserved populations. Washington, DC: The National Academies Press.
8.
Institute of Medicine. (2011). Advancing oral health in America. Washington, DC. The National Academies Press.
9.
ManskiR. J.MoellerJ. F.ChenH.St. ClairP. A.SchimmelJ.PepperJ. V. (2012). Wealth effect and dental care utilization in the U.S. Journal of Public Health Dentistry, 72, 179–189.
10.
ManskiR. J.MoellerJ. F.ChenH.SchimmelJ.St. ClairP. A.PepperJ. V. (2014). Dental usage under changing economic conditions. Journal of Public Health Dentistry, 74, 1–12.
11.
ManskiR. J.MoellerJ. F.ChenH.St. ClairP. A.SchimmelJ.MagderL.PepperJ. V. (2010). Dental care expenditures and retirement. Journal of Public Health Dentistry, 70, 148–155.
12.
RAND. (2008). HRS Data, Version H. Produced by the RAND Center for the Study of Aging, with funding from the National Institute on Aging and the Social Security Administration. Santa Monica, CA (February 2008).
13.
Research Triangle Institute. (1995) SUDAAN software for analysis of correlated data. Release 6.40. Research Triangle Park, NC: Author.
14.
Statacorp. (2001). Stata statistical software: Release 7.0. College Station, TX: Stata Corporation.
15.
St. ClairP.BlakeD.BugliariD. (2010, 3). RAND HRS data documentation, version J. Santa Monica, CA: RAND Center for the Study of Aging, Labor and Population Program.
