Costs for Statutorily Insured Dental Services in Older Germans 2012–2017
Objectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs for: (1...
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doaj-3c14ae414fac4e059d3016a22ab60c7b2021-07-01T00:46:16ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-06-01186669666910.3390/ijerph18126669Costs for Statutorily Insured Dental Services in Older Germans 2012–2017Aleksander Krasowski0Joachim Krois1Sebastian Paris2Adelheid Kuhlmey3Hendrik Meyer-Lueckel4Falk Schwendicke5Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, GermanyDepartment of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, GermanyDepartment of Operative and Preventive Dentistry, Charité—Universitätsmedizin, 10117 Berlin, GermanyInstitute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin, 10117 Berlin, GermanyDepartment of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, 3012 Bern, SwitzerlandDepartment of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, GermanyObjectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs for: (1) examination, assessments and advice, (2) operative, (3) surgical, (4) prosthetic, (5) periodontal, (6) preventive and (7) outreach services. Association of utilization with: (1) sex, (2) age, (3) region, (4) social hardship status, (5) International Disease Classification (ICD-10) diagnoses and (6) Diagnoses Related Groups (DRGs) was explored. Results: 404,610 individuals with a mean (standard deviation, SD) age 81.9 (5.4 years) were followed, 173,733 did not survive follow-up. Total mean costs were 129.61 (310.97) euro per capita; the highest costs were for prosthetic (54.40, SD 242.89 euro) and operative services (28.40, SD 68.38 euro), examination/advice (21.15, SD 28.77 euro), prevention (13.31, SD 49.79 euro), surgery (5.91, SD 23.91 euro), outreach (4.81, SD 28.56 euro) and periodontal services (1.64, SD 7.39 euro). The introduction of new fee items for outreach and preventive services between 2012 and 2017 was reflected in costs. Total costs decreased with increasing age, and this was also found for all service blocks except outreach and preventive services. Costs were higher in those with social hardship status, and in Berlin than Brandenburg and Mecklenburg-Western Pomerania. Certain general health conditions were associated with increased or decreased costs. Conclusions: Costs were associated with sex, social hardship status, place of living and general health conditions. Clinical significance: Dental services costs for the elderly in Germany are unequally distributed and, up to a certain age or health status, generated by invasive interventions mainly. Policy makers should incentivize preventive services earlier on and aim to distribute expenses more equally.https://www.mdpi.com/1660-4601/18/12/6669accesscostsgeriatricsgerodontologyhealth services researchhealth economics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Aleksander Krasowski Joachim Krois Sebastian Paris Adelheid Kuhlmey Hendrik Meyer-Lueckel Falk Schwendicke |
spellingShingle |
Aleksander Krasowski Joachim Krois Sebastian Paris Adelheid Kuhlmey Hendrik Meyer-Lueckel Falk Schwendicke Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 International Journal of Environmental Research and Public Health access costs geriatrics gerodontology health services research health economics |
author_facet |
Aleksander Krasowski Joachim Krois Sebastian Paris Adelheid Kuhlmey Hendrik Meyer-Lueckel Falk Schwendicke |
author_sort |
Aleksander Krasowski |
title |
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 |
title_short |
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 |
title_full |
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 |
title_fullStr |
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 |
title_full_unstemmed |
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017 |
title_sort |
costs for statutorily insured dental services in older germans 2012–2017 |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-06-01 |
description |
Objectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs for: (1) examination, assessments and advice, (2) operative, (3) surgical, (4) prosthetic, (5) periodontal, (6) preventive and (7) outreach services. Association of utilization with: (1) sex, (2) age, (3) region, (4) social hardship status, (5) International Disease Classification (ICD-10) diagnoses and (6) Diagnoses Related Groups (DRGs) was explored. Results: 404,610 individuals with a mean (standard deviation, SD) age 81.9 (5.4 years) were followed, 173,733 did not survive follow-up. Total mean costs were 129.61 (310.97) euro per capita; the highest costs were for prosthetic (54.40, SD 242.89 euro) and operative services (28.40, SD 68.38 euro), examination/advice (21.15, SD 28.77 euro), prevention (13.31, SD 49.79 euro), surgery (5.91, SD 23.91 euro), outreach (4.81, SD 28.56 euro) and periodontal services (1.64, SD 7.39 euro). The introduction of new fee items for outreach and preventive services between 2012 and 2017 was reflected in costs. Total costs decreased with increasing age, and this was also found for all service blocks except outreach and preventive services. Costs were higher in those with social hardship status, and in Berlin than Brandenburg and Mecklenburg-Western Pomerania. Certain general health conditions were associated with increased or decreased costs. Conclusions: Costs were associated with sex, social hardship status, place of living and general health conditions. Clinical significance: Dental services costs for the elderly in Germany are unequally distributed and, up to a certain age or health status, generated by invasive interventions mainly. Policy makers should incentivize preventive services earlier on and aim to distribute expenses more equally. |
topic |
access costs geriatrics gerodontology health services research health economics |
url |
https://www.mdpi.com/1660-4601/18/12/6669 |
work_keys_str_mv |
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