Abstract
Background
Inequalities in oral health and care are long recognized in Canada, with public health environments increasingly focusing on issues of equity and access to care. How does Canada publicly insure for diseases that are largely preventable, minimally experienced by the majority, but that still cause tremendous suffering among the socially marginalized? We consider this dynamic by asking Canadians their opinions on publicly financed dental care.
Methods
Data were collected from 1,006 Canadian adults through a telephone interview survey using random digit dialling and computer-assisted telephone interview technology. Simple descriptive and bivariate analyses were undertaken to assess relationships among variables, with logistic regression odds ratios calculated for significant relations.
Results
Canadians support the idea of universal coverage for dental care, also recognizing the need for care to specific groups. Generally preferring to access public care through the private sector, Canadians support the idea of opting out, and expect those who access such care to financially contribute at point of service.
Conclusion
Support for publicly financed dental care is indicative of a general support for a basic right to health care. Within the limits of economy, the distribution of oral disease, and Canadian values on health, the challenge remains to define what we think is equitable within this sector of the health care system. This question is ultimately unanswerable through any survey or statistical means, and must, to become relevant, be openly promoted and debated in the social arena, engaging Canadians and their sense of individual and social responsibility.
MeSH terms: Dental care delivery, public opinion, access to health care, policy
Résumé
Contexte
Au Canada, on reconnaît depuis longtemps que des inégalités existent en matière de santé bucco-dentaire, les milieux de la santé publique insistant de plus en plus sur les questions d’équité et d’accès aux soins. Comment le Canada peut-il se permettre d’offrir des services assurables contre des problèmes de santé facilement évitables qui, même s’ils ne touchent qu’une infime partie de la population, causent néanmoins d’énormes souffrances chez les personnes en marge de la société? Nous nous sommes penchés sur la question en sondant l’opinion des Canadiens sur les soins dentaires subventionnés par l’État.
Méthode
Nous avons recueilli des données auprès de 1 006 Canadiens adultes par le biais d’un sondage téléphonique à composition aléatoire assisté par ordinateur. De simples analyses descriptives et bivariées ont été effectuées afin d’évaluer les relations entre les variables, en calculant un rapport de cotes par régression logistique pour les relations significatives.
Résultats
Les Canadiens sont en faveur d’une couverture universelle des soins dentaires et reconnaissent également les besoins en soins dentaires de certains groupes. S’ils préfèrent généralement avoir accès aux soins publics par la voie du secteur privé, ils sont favorables à l’idée d’une option de retrait et s’attendent à ce que ceux qui accèdent à de tels soins contribuent financièrement au point de service.
Conclusion
L’appui accordé au financement public des soins dentaires témoigne de la reconnaissance générale du droit fondamental aux soins de santé. Compte tenu des limites budgétaires, de la répartition des problèmes de santé buccale et des valeurs des Canadiens relativement à la santé, il reste à définir ce que nous jugeons être équitable pour ce secteur du réseau de la santé. Une réponse à cette question ne saurait être obtenue par le biais d’un sondage ou de données statistiques. Pour être pertinente, la question doit être présentée et débattue dans l’arène sociale et faire ainsi appel aux Canadiens et à leur sens des responsabilités individuelles et sociales.
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