Utilization of dental services of older persons after onset of home care ­­: an observational study from the InSEMaP research project based on German insurance claims data

Abstract

Background: Maintaining a good oral health is important for general health, nutrition, and quality of life. Nevertheless, the utilization of dental services decreases with age. Persons in need of home care, in particular, might face difficulties organizing dental visits due to a decreasing functional status. The aim of this study was to analyze the utilization of dental services of older persons after the onset of need for home care. Methods: In a retrospective cohort study with statutory health insurance claims data from 2015–2020, we compared persons aged ≥ 60 years with incident and lasting need for home care in 2017 (study group) with a control group without need for care. Both groups had at least one routine dental service during the preceding 2-year baseline period. We applied entropy balancing to adjust for differences in patient characteristics. We analyzed the utilization of dental services over a 3-year follow-up. We analyzed the probability of utilization and the number of dental services using weighted logistic and negative binomial regressions. Results: We identified 26,818 persons in the study and 393,540 in the control group. We obtained a lower probability for any dental service use in the study group (0.9) than the control group (0.94; risk ratio: 0.96; 98.75% confidence interval: 0.96–0.97). Moreover, persons in the study group utilized on average fewer dental services than those in the control group (rate ratio: 0.92; 98.75% confidence interval: 0.91–0.93). Conclusion: The onset of need for home care was associated with a decreased utilization of dental services for older persons with prior dental service utilization, expanding existing evidence. There is a need to improve oral healthcare for persons in need of home care.