Inequality in Utilization of Dental Services: A Systematic Review and Meta-analysis

作者：Sophie Franziska Reda, Seif Reda, W. Murray Thomson, Falk Schwendicke · 发表于：American Journal of Public Health · 年份：2017 · DOI：10.2105/ajph.2017.304180 · 被引用次数：264 · 研究领域：Dental Health and Care Utilization、Dental Education, Practice, Research、Dental Research and COVID-19

BACKGROUND: Dental diseases are among the most prevalent conditions worldwide, with universal access to dental care being one key to tackling them. Systematic quantification of inequalities in dental service utilization is needed to identify where these are most pronounced, assess factors underlying the inequalities, and evaluate changes in inequalities with time. OBJECTIVES: To evaluate the presence and extent of inequalities in dental services utilization. SEARCH METHODS: We performed a systematic review and meta-analysis by searching 3 electronic databases (MEDLINE, Embase, Cochrane Central Database), covering the period from January 2005 to April 2017. SELECTION CRITERIA: We included observational studies investigating the association between regular dental service utilization and sex, ethnicity, place of living, educational or income or occupational position, or insurance coverage status. Two reviewers undertook independent screening of studies and made decisions by consensus. DATA COLLECTION AND ANALYSIS: Our primary outcome was the presence and extent of inequalities in dental service utilization, measured as relative estimates (usually odds ratios [ORs]) comparing different (high and low utilization) groups. We performed random effects meta-analysis and subgroup analyses by region, and we used meta-regression to assess whether and how associations changed with time. MAIN RESULTS: A total of 117 studies met the inclusion criteria. On the basis of 7 830 810 participants...