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Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain

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Abstract

Objective

To estimate the prevalence of catastrophic health expenditure due to dental healthcare (CHED) in Spain, quantify its intensity and examine the related sociodemographic household characteristics.

Methods

Data from the Spanish Household Budget Survey, which addresses more than 20,000 households each year for the period 2008–2015 were included, and the methodology proposed by Wagstaff and van Doorslaer was followed. The prevalence (number of households that devote more than a certain threshold of their income to such payments) and intensity (amount that exceeds a certain percentage of income) were estimated. Ordered logistic regression models were estimated to analyse the sociodemographic factors associated with the prevalence of catastrophic payments.

Results

The prevalence and intensity remained stable during the period under analysis. In terms of prevalence, a mean proportion of 7.36% of the population dedicated, in terms of intensity, more than 10% of their resources to dental care payments [mean: €292.75 per year (SD €2144.14)] and 2.05% dedicated more than 40% [mean: €143.02 per year (SD €1726.42)]. This represents 36.32% and 51.34% (for the thresholds of 10% and 40%) of the total catastrophic expenditure derived from out-of-pocket payments for dental healthcare in Spain.

Conclusion

This study shows that a significant proportion of catastrophic healthcare payments correspond to dental services. Being male, aged over 40 years, unattached (single, separated, divorced or widowed), having a low level of education, a low household income, being unemployed and living in an urban area are all associated with a greater risk of CHED. This finding highlights the need to establish policies aimed at increasing dental care coverage to mitigate related financial burdens on a large part of the Spanish population.

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Funding

This research was funded by Research Group on Food, Economy and Society of University of Castilla-La Mancha, Grant number 2020-GRIN-29191, R+D Groups.

Author information

Authors and Affiliations

  1. Castilla-La Mancha Health Services, SESCAM, Hospital of Cuenca, C/ Hermandad de Donantes de Sangre, 1, 16 002, Cuenca, Spain

    Samuel López-López

  2. Department of Economic Analysis and Finance, University of Castilla-La Mancha, Avda. Los Alfares, 44, 16 071, Cuenca, Spain

    Raúl del Pozo-Rubio

  3. Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Campus de Somosaguas s/n, Pozuelo de Alarcón, 28 223, Madrid, Spain

    Marta Ortega-Ortega

  4. Department of Economic Analysis and Finance, University of Castilla-La Mancha, Plaza de la Universidad s/n, 02 001, Albacete, Spain

    Francisco Escribano-Sotos

  5. Research Group on Food, Economy and Society, University of Castilla-La Mancha, Albacete, Spain

    Raúl del Pozo-Rubio & Francisco Escribano-Sotos

Authors
  1. Samuel López-López
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  2. Raúl del Pozo-Rubio
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  3. Marta Ortega-Ortega
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  4. Francisco Escribano-Sotos
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Contributions

SLL and RPR carried out the data preparation and the statistical analysis. MOO and FES have contributed to write the manuscript. All the authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Samuel López-López.

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López-López, S., del Pozo-Rubio, R., Ortega-Ortega, M. et al. Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain. Eur J Health Econ 23, 1187–1201 (2022). https://doi.org/10.1007/s10198-021-01420-y

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