摘要：Objectives. We examined dental care utilization transition dynamics between 2004 and 2006 in the context of changing dental coverage status. Methods. We used data from the Health and Retirement Study for persons aged 51 years and older to estimate a multivariable model of dental care use transitions with controls for dental coverage and retirement transitions and other potentially confounding covariates. Results. We found that Americans aged 51 years and older who lost dental coverage between the 2004 and 2006 survey periods were more likely to stop dental care use between periods, and those who gained coverage were more likely to start dental care use between periods, than those without coverage in both periods. Conclusions. Dental coverage transitions and status have a strong effect on transitions in dental care use. Given that retirement is a time when many experience a loss of dental coverage, older adults may be at risk for sporadic dental care and even stopping use, leading to worse dental and potentially overall health. Regular dental care is imperative for maintaining good oral health. The likelihood of seeking dental care has been shown to be highly correlated with having dental insurance coverage, meaning that persons who experience changes in dental insurance status may have irregular dental care utilization patterns. Indeed, it has been shown that persons who expect a change in their dental insurance status modify their use patterns to stock up before losing coverage. 1 For most in the United States, dental insurance coverage is job-based, meaning that those who change jobs or leave employment altogether are most at risk of changes in dental coverage status and, therefore, at highest risk of irregular utilization patterns. Working-age adults who lose dental coverage as a consequence of a change in employment status may be able to obtain coverage from a spouse or through another employer. However, older adults around the age of retirement may not have such options because the majority become eligible for Medicare coverage at 65 years of age, which apart from a small but growing percentage of beneficiaries in Medicare Advantage programs does not offer dental benefits. 2 – 4 Previous evidence has shown that those who are retired have lower levels of dental care utilization and lower rates of coverage than have those who are not retired. 5 – 8 The transition from work to retirement is associated with a loss in dental coverage. 6 Taken together, these findings imply that the transition from work to retirement may lead to irregular patterns of dental care utilization. This irregular care could be problematic unless those at or near retirement age could avoid high-cost treatments later in life through regular preventive care. 9 We examined dental care utilization transition dynamics in the context of changing dental coverage status among a population around the age of retirement. We used data from the Health and Retirement Study (HRS) to assess the characteristics of persons aged 51 years and older based on whether they had, maintained, or changed their dental care use status between the 2004 and 2006 waves of the HRS. In particular, we assessed how changes in dental coverage and changes in retirement status affected the relative likelihood of having irregular dental care utilization patterns.
