Before-after (1998 and 2008) trend analyses on regional clustering of clinical dentist-to-population ratio in all 1,976 municipalities of Japan

Purpose: The main purpose of this study was to obtain geographic clustering information in order to identify shortages (“cold spots”) and surpluses (“hot spots”) of dentists in all municipalities of Japan. Methods: Pretreatment steps were conducted to recover the lost comparability between pre-1998 and post-2008 data due to the large-scale merging of municipalities (42.1% reduction) in the Heisei era. Moran’s I, LISA and spatial multiple regression analyses with AIC were performed to verify regional clustering. Dependent variables of the regression analyses were the clinical dentist-to-population ratio in 2008 (Model 1) and the difference between 1998 and 2008 (Model 2). Results: The R2 was 0.8379 (p<0.0001) for Model 1 and 0.5832 (p<0.0001) for Model 2. The initial dentist-to-population ratio in 1998 showed the highest significance in both models. However, the coefficient of Model 2 was negative, which was exactly the opposite of that of Model 1. Furthermore, indices relating to urbanization and hospital dentist-to-population ratio in 1998 were also highly significant (p<0.01) after adjustment for confounding factors. High- High clustered municipalities are located in most urbanized areas, whereas Low-Low clustered municipalities are located in remote areas far from urbanized areas. This study revealed that factors which attract dental clinics are urbanization and hospitals with dental care capabilities. Conclusion: Clinical dentist-topopulation ratios have improved only in municipalities in urbanized areas in the past ten years. On the contrary, accessibility of dental treatment has not improved in remote/isolated areas

Risk factors related to the reduction of subjective taste ability in middle-to old-aged nursing home residents in Sri Lanka : a cross-sectional study

The purpose of this study is to verify the factors significantly related to the reduction of subjective taste ability of 1,015 middle-aged and elderly (50 - 96 years old) at 25 randomized selected nursing homes in Sri Lanka. Binary logistic regression analyses by gender were performed using IBM SPSS on following variables. A dependent variable is taste ability, and 27 independent variables are age, daily lifestyle, nutritional problems, general status, dental status and physiological thresholds of taste abilities (sweet, salt, sour, bitter, and umami). Smell ability (p < 0.001 - 0.05) and the Self-Report Questionnaire, 20-item version :SRQ 20 (p < 0.01 - 0.05) were significant risk factors of reducing taste ability in both genders. Especially, smell ability was closely linked to taste ability. Existence of comprehensive perception of “flavor” composed of taste and smell ability was illustrated. Significant gender differences factors were observed in long term care needs (p < 0.05), sleeping (p < 0.01 - 0.001), bowel condition (p < 0.05) in males; and height (p < 0.05), weight (p < 0.05), BMI 3 categories (p < 0.05), and brushing (p < 0.05) in females. Other variables such as age and five types of physiological taste ability were not significant in both genders. The results of this investigation also strongly indicated that the perception of subjective sense of taste was different from the objective sense of taste. Epidemiological studies such as cohort or intervention studies focusing on a relationship between subjective taste ability and sense of smell are necessary to identify more accurate and changeable risk factors for dysgeusia in order to improve elderly’s nutritional intake in Sri Lanka

Trends in dental expenditures in Japan with a universal health insurance system.

BackgroundThe government of Japan has spent a significant amount on dental healthcare, but it remains unknown how the spending varies across age, type of service, and time. This study describes trends in dental expenditures in Japan.MethodsThis descriptive study used two national data sources: Estimates of National Medical Care Expenditure and Survey on Economic Conditions in Health Care. We obtained annual total and average per capita dental expenditures by age in Japan from 1984 to 2020 and estimated the proportions of types of service from 1996 to 2021. All costs were adjusted for the 2020 Consumer Price Index (1 US dollar ≈ 100 yen in 2020).ResultsTotal dental expenditures increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020. In particular, total and average per capita dental spending for older persons showed a rapid increase (total: from 185 billion yen in 1984 to 1.18 trillion yen in 2020; average per capita: from 15,500 yen in 1984 to 32,800 yen in 2020), contributing to the total amount increase. The crown restoration and prosthesis category amounted to 50.3% of the total expenditure in 1996, and this proportion declined to 32.4% by 2021. In 0-14 years persons, expenses on the crown restoration and prosthesis category decreased while the medical management category (mainly including fees for a management plan for oral diseases or oral functions) increased. In persons aged 65 years or older, expenses on the crown restoration and prosthesis category decreased, with increasing expenses in the medical management and at-home treatment categories.ConclusionThe amount of dental spending in Japan substantially increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020), a 1.53-fold increase. The observed changes in annual dental spending varied across age groups and types of service

Total and average per capita dental expenditures in Japan.

Total and average per capita dental expenditures in Japan.</p

Amount and proportion of services per year.

BackgroundThe government of Japan has spent a significant amount on dental healthcare, but it remains unknown how the spending varies across age, type of service, and time. This study describes trends in dental expenditures in Japan.MethodsThis descriptive study used two national data sources: Estimates of National Medical Care Expenditure and Survey on Economic Conditions in Health Care. We obtained annual total and average per capita dental expenditures by age in Japan from 1984 to 2020 and estimated the proportions of types of service from 1996 to 2021. All costs were adjusted for the 2020 Consumer Price Index (1 US dollar ≈ 100 yen in 2020).ResultsTotal dental expenditures increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020. In particular, total and average per capita dental spending for older persons showed a rapid increase (total: from 185 billion yen in 1984 to 1.18 trillion yen in 2020; average per capita: from 15,500 yen in 1984 to 32,800 yen in 2020), contributing to the total amount increase. The crown restoration and prosthesis category amounted to 50.3% of the total expenditure in 1996, and this proportion declined to 32.4% by 2021. In 0–14 years persons, expenses on the crown restoration and prosthesis category decreased while the medical management category (mainly including fees for a management plan for oral diseases or oral functions) increased. In persons aged 65 years or older, expenses on the crown restoration and prosthesis category decreased, with increasing expenses in the medical management and at-home treatment categories.ConclusionThe amount of dental spending in Japan substantially increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020), a 1.53-fold increase. The observed changes in annual dental spending varied across age groups and types of service.</div

Trends in the total and average per capita dental expenditures in Japan.

Trends in the total and average per capita dental expenditures in Japan.</p

Amount and proportion of services per year for people aged 0–14 years.

Amount and proportion of services per year for people aged 0–14 years.</p