Background: The financial burden of oral diseases is getting more important. The aim of this study was to describe the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of this inequality for Chinese adults.
Methods: A secondary analysis used the data of 13,464 adults from the 4 th National Oral Health Epidemiological Survey (NOHES) in China was undertook. The dental expenditure in the past year divided into out-of-pocket and health insurance payments was collected. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. Decomposition of concentration index was made to explore the associated socioeconomic determinants.
Results: Mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval, CI: 18.83,22.26) and for those who used dental service in the past year, the number was $100.95(95%CI: 93.22,108.68). More than 90% of the expenditure was out-of-pocket. Horizontal inequality indices and Kakwani indices were both negative and that indicated inequalities were in favor of the rich. The socioeconomic factors including income, urban or rural area and educational attainment were the main contributors to the inequality of dental expenditure.
Conclusion: Dental expenditure for Chinese adults was not too much under a pretty low utilization. The payments of dental expenditure were regressive. People with the most oral health need didn’t meet appropriate dental services. Socioeconomic characteristic including household income, area and education was the main determinant while oral hygiene practice and self-reported oral health were the main individual determinants for the inequality of dental expenditure.