Demographic and rural-urban variations in dental service utilization in Taiwan.

INTRODUCTION This study assesses whether demographic and rural-urban variations in dental care service utilization still exist in Taiwan after 15 years of the implementation of universal health insurance coverage, which largely reduces financial barriers to dental care. METHODS The data analysed in this cohort study were based on a random sample of one million beneficiaries retrieved from Taiwan's National Health Insurance Research Database (NHIRD) in 2005. The follow-up was made between 2005 and 2010. Poisson regression models were used to explore the associations of dental service utilization rates with urbanization and demographic characteristics. RESULTS The highest and lowest rates of preventive dental care were obtained in people aged 55-64 years (579.2/1000 person-years) and <15 years (178.6/1000 person-years). The corresponding figures for curative care were 1592.0/1000 person-years (<15 years) and 757.2/1000 person-years (35-44 years). Compared with the people living in the least urbanized areas, those from the most urbanized areas presented significantly higher rates of preventive and curative dental services; a greater estimated rate ratio was noted for preventive services than for curative services (1.57 vs 1.42). CONCLUSIONS The urban-rural disparity in dental care service utilization still exists after 15 years of the implementation of the national health insurance in Taiwan, suggesting that factors other than affordability may play roles in such disparity.