Abstract
Objective
Canada’s national system of health insurance facilitates equitable access to health care; however, since dental care is generally privately financed and delivered, access to oral health care remains uneven and inequitable. To avoid the upfront costs, many argue that socially marginalized groups should seek oral health care from medical providers. This study therefore explored the rates and numbers of visits to physicians for oral health-related diagnoses in Ontario, Canada’s most populated province.
Methods
A retrospective secondary data analysis of health system utilization in Ontario was conducted for visits to physicians for oral health-related diagnoses. Data for all Ontario Health Insurance Plan (OHIP) approved billing claims were accessed over 11 fiscal years (2001–2011). Age- and sex-adjusted rates were calculated.
Results
Approximately 208,375 visits per year, with an average of 1,298/100,000 persons, were made to physicians for oral health-related diagnoses. Women, irrespective of the year, made more visits, and there was an increasing trend in visits made by elderly people.
Conclusion
The number of people visiting physicians for oral health reasons is arguably high. The public health system is being billed for services for oral health issues that the provider is not appropriately trained to treat. Provision of timely and accessible oral health care for socially marginalized populations needs to be prioritized in health care policy.
Key words: Medical billing, health services, health policy, access to oral health care
Résumé
Objectif
Le système national d’assurance-santé du Canada facilite l’accès équitable aux soins de santé; toutefois, comme les soins dentaires sont généralement financés et offerts à titre privé, l’accès aux soins buccodentaires demeure inégal et inéquitable. Pour éviter les coûts initiaux, beaucoup sont d’avis que les groupes socialement marginalisés devraient obtenir des soins buccodentaires auprès de dispensateurs de soins médicaux. Notre étude explore donc les taux et le nombre des visites médicales pour obtenir des diagnostics de santé buccodentaire en Ontario, la province la plus peuplée du Canada.
Méthode
Nous avons mené une analyse rétrospective de données secondaires sur l’utilisation du système de santé en Ontario pour ce qui est des visites médicales pour obtenir des diagnostics de santé buccodentaire. Nous avons consulté les données de toutes les demandes de paiement des médecins approuvées par le Régime d’assurance-maladie de l’Ontario (RAMO) au cours de 11 exercices (2001–2011 ). Les taux rajustés selon l’âge et le sexe ont été calculés.
Résultats
Il y a eu environ 208 375 visites médicales par année (1298 p. 100 000 personnes en moyenne) pour obtenir des diagnostics de santé buccodentaire. Les femmes, peu importe l’année, ont fait davantage de ces visites, et le nombre de visites effectuées par les personnes âgées affiche une tendance croissante.
Conclusion
Le nombre de personnes consultant des médecins pour des raisons de santé buccodentaire est probablement élevé. Le système de santé publique est facturé pour des services liés à des problèmes de santé buccodentaire que les dispensateurs n’ont pas la formation nécessaire pour traiter. La politique de soins de santé devrait offrir en priorité des soins buccodentaires rapides et accessibles aux populations socialement marginalisées.
Mots Clés: facturation des services médicaux, services de santé, politique de santé, accès aux soins buccodentaires
Footnotes
Acknowledgements: In-kind support from South Riverdale Community Health Centre and Association of Ontario Health Centres.
Conflict of Interest: None to declare.
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