Socio-demographic predictors of not having private dental insurance coverage: machine-learning algorithms may help identify the disadvantaged.
Humans
Female
Adult
Male
Middle Aged
Cross-Sectional Studies
Insurance, Dental
/ statistics & numerical data
Machine Learning
Vulnerable Populations
Adolescent
Aged
Young Adult
Health Services Accessibility
/ statistics & numerical data
Socioeconomic Factors
Insurance Coverage
/ statistics & numerical data
Algorithms
Ontario
Sociodemographic Factors
Canada
Access to dental care
Barriers to dental care
Dental care utilization
Dental insurance
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
23 May 2024
23 May 2024
Historique:
received:
22
11
2023
accepted:
16
05
2024
medline:
24
5
2024
pubmed:
24
5
2024
entrez:
23
5
2024
Statut:
epublish
Résumé
For accessing dental care in Canada, approximately 62% of the population has employment-based insurance, 6% have some publicly funded coverage, and 32% have to pay out-of pocket. Those with no insurance or public coverage find dental care more unaffordable compared to those with private insurance. To support the development of more comprehensive publicly funded dental care programs, it is important to understand the socio-demographic attributes of all those, who find dental care unaffordable. This study is a secondary analysis of the data collected from Ontarians during the latest available cycle of the Canadian Community Health Survey (2017-18), a cross-sectional survey that collects information on health status, health care utilization, and health determinants for the Canadian population. First, bivariate analysis was conducted to determine the characteristics of Ontarians who lack dental insurance. Afterwards, we employed machine learning (ML) to analyze data and identify risk indicators for not having private dental insurance. Specifically, we trained several supervised ML models and utilized Shapley additive explanations (SHAP) to determine the relative feature importance for not having private dental insurance from the best ML model [the gradient boosting (GBM)]. Approximately one-third of Ontarians do not have private insurance coverage for dental care. Individuals with an income below $20,000, those unemployed or working part-time, seniors aged above 70, and those unable to afford to have their own housing are more at risk of not having private dental insurance, leading to financial barriers in accessing dental care. In the future, government-funded programs can incorporate these identified risk indicators when determining eligible populations for publicly funded dental programs. Understanding these attributes is critical for developing targeted and effective interventions, ensuring equitable access to dental care for Canadians.
Sections du résumé
BACKGROUND
BACKGROUND
For accessing dental care in Canada, approximately 62% of the population has employment-based insurance, 6% have some publicly funded coverage, and 32% have to pay out-of pocket. Those with no insurance or public coverage find dental care more unaffordable compared to those with private insurance. To support the development of more comprehensive publicly funded dental care programs, it is important to understand the socio-demographic attributes of all those, who find dental care unaffordable.
METHODS
METHODS
This study is a secondary analysis of the data collected from Ontarians during the latest available cycle of the Canadian Community Health Survey (2017-18), a cross-sectional survey that collects information on health status, health care utilization, and health determinants for the Canadian population. First, bivariate analysis was conducted to determine the characteristics of Ontarians who lack dental insurance. Afterwards, we employed machine learning (ML) to analyze data and identify risk indicators for not having private dental insurance. Specifically, we trained several supervised ML models and utilized Shapley additive explanations (SHAP) to determine the relative feature importance for not having private dental insurance from the best ML model [the gradient boosting (GBM)].
RESULTS
RESULTS
Approximately one-third of Ontarians do not have private insurance coverage for dental care. Individuals with an income below $20,000, those unemployed or working part-time, seniors aged above 70, and those unable to afford to have their own housing are more at risk of not having private dental insurance, leading to financial barriers in accessing dental care.
CONCLUSION
CONCLUSIONS
In the future, government-funded programs can incorporate these identified risk indicators when determining eligible populations for publicly funded dental programs. Understanding these attributes is critical for developing targeted and effective interventions, ensuring equitable access to dental care for Canadians.
Identifiants
pubmed: 38783219
doi: 10.1186/s12889-024-18868-1
pii: 10.1186/s12889-024-18868-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1386Informations de copyright
© 2024. The Author(s).
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