IMPAC T OF GOVERNMENT POLICY ON ACCESS TO DENTAL CARE FOR VULNERABLE GROUPS

Abstract

Background : Since 1 October 2015, Belgium dentists are no longer allowed to use third-party payment for people who are not “increased reimbursement beneficiaries” but who are nevertheless caught in a temporarily difficult financial situation and should also be considered as vulnerable groups.

Aim : To investigate the impact of the abolition of third-party payment on access to dental care for vulnerable groups in deprived neighbourhoods in the city of Ghent.

Methods : The proportion of increased reimbursement beneficiaries in three primary health care centres and one dental office, integrated in a primary health care centre, was tracked during the years 2014 to 2016. The Chi-square test was used to compare differences between the years. An increase in the proportion of increased reimbursement beneficiaries can be equated with a decrease of other vulnerable groups.

Results : During the years 2014, 2015 and 2016 32,794 patients were registered in the three primary healthcare centres. 3,294 (31.8%), 3,554 (32.8%) and 4,217 (36.4%) were “increased reimbursement beneficiaries” respectively. Over these three years 5,302 of them visited the dental office. In 2014 620 out of 1,675 (29.9%), in 2015 505 out of 1,443 ( 35.0%) and in 2016 948 out of 2,158 ( 43.4%) were “increased reimbursement beneficiaries”. Both in the health care centres and in the dental office a statistically significant increase was observed in the proportion of increased reimbursement beneficiaries. This increase was higher for the dental office.

Conclusion: The abolition of the use of third-party payment for other groups, then the increased reimbursement beneficiaries, caused a change in dental attendance resulting in lower attendance for other vulnerable groups than increased reimbursement beneficiaries. It seems that fewer patients belonging to these vulnerable groups, who do not enjoy the benefits of an increased reimbursement and therefore cannot benefit from third-party payment, to have access to dental care.