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Abstract
Objectives
The objective of this study was to examine the difference in dental care utilization between diabetics (diabetes group) and nondiabetics (normal group).
Methods
We examined the data of 5108 subjects enrolled in the Korea Health Panel Survey, every year for three years between 2010 and 2012. Of these, 458 subjects were included in the diabetes group and 458 in the normal group using the propensity score matching method to control confounding variables. To compare dental care utilization by the diabetes and normal groups, we examined the odds ratio (OR) and 95% confidence interval (CI) using a generalized estimating equation.
References
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Table 1.
Demographic characteristics (Reference year: 2010)
|
Total data set |
Analysis data set by PSM |
|||||
|---|---|---|---|---|---|---|
| Normal group (n=4,351) | Diabetic group (n=757) | P-value | Normal group (n=458) | (n=458) Diabetic group | P-value | |
| Age (years) | <0.001† | 0.920† | ||||
| 20-29 | 1,036 (23.8) | 2 (0.3) | 2 (0.4) | 2 (0.4) | ||
| 30-39 | 1,350 (31.0) | 13 (1.7) | 16 (3.5) | 13 (2.8) | ||
| 40-49 | 1,194 (27.4) | 57 (7.5) | 54 (11.8) | 57 (12.4) | ||
| 50-59 | 504 (11.6) | 152 (20.1) | 143 (31.2) | 143 (31.2) | ||
| 60-69 | 193 (4.4) | 270 (35.7) | 169 (36.9) | 175 (38.2) | ||
| 70-79 | 59 (1.4) | 229 (30.3) | 59 (12.9) | 59 (12.9) | ||
| ≥80 | 15 (0.3) | 34 (4.5) | 15 (3.3) | 9 (2.0) | ||
| Mean±SD | 39.2±11.9 | 64.5±10.6 | <0.001‡ | 59.2±11.1 | 60.0±10.4 | 0.287‡ |
| Sex | <0.001† | 0.595† | ||||
| Male | 2,415 (55.5) | 361 (47.7) | 257 (56.1) | 249 (54.4) | ||
| Female | 1,936 (44.5) | 396 (52.3) | 201 (43.9) | 209 (45.6) | ||
| Marital Status | <0.001† | 0.694† | ||||
| Single | 1,404 (32.3) | 11 (1.5) | 9 (2.0) | 10 (2.2) | ||
| Married | 2,783 (64.0) | 568 (75.0) | 379 (82.8) | 369 (80.6) | ||
| Divorce & etc. | 164 (3.8) | 178 (23.5) | 70 (15.3) | 79 (17.2) | ||
| Educational level | <0.001† | 0.713† | ||||
| <Primary school | 218 (5.0) | 369 (48.7) | 167 (36.5) | 166 (36.2) | ||
| Middle school | 244 (5.6) | 130 (17.2) | 91 (19.9) | 86 (18.8) | ||
| High school | 1,544 (35.5) | 174 (23.0) | 140 (30.6) | 134 (29.3) | ||
| ≥College | 2,345 (53.9) | 84 (11.1) | 60 (13.1) | 72 (15.7) | ||
| Health Insurance | <0.001† | 0.186† | ||||
| Company health insurance | 2,856 (65.6) | 434 (57.3) | 289 (63.1) | 271 (59.2) | ||
| Regional health insurance | 1,430 (32.9) | 222 (29.3) | 148 (32.3) | 154 (33.6) | ||
| Medicare and etc. | 65 (1.5) | 101 (13.3) | 21 (4.6) | 33 (7.2) | ||
| Family income level | <0.001† | 0.959† | ||||
| Level 1 | 306 (7.0) | 242 (32.0) | 92 (20.1) | 96 (21.0) | ||
| level 2 | 763 (17.5) | 182 (24.0) | 101 (22.1) | 107 (23.4) | ||
| level 3 | 1,006 (23.1) | 142 (18.8) | 101 (22.1) | 101 (22.1) | ||
| level 4 | 1,144 (26.3) | 104 (13.7) | 85 (18.6) | 82 (17.9) | ||
| level 5 | 1,132 (26.0) | 87 (11.5) | 79 (17.2) | 72 (15.7) | ||
| Toothbrushing rate | ||||||
| After breakfast | 2,802 (64.4) | 556 (73.4) | <0.001† | 325 (71.0) | 327 (71.4) | 0.884† |
| After lunch | 1,979 (45.5) | 224 (29.6) | <0.001† | 144 (31.4) | 148 (32.3) | 0.777† |
| After supper | 1,799 (41.3) | 322 (42.5) | 0.540† | 207 (45.2) | 195 (42.6) | 0.424† |
| Before bedtime | 2,680 (61.6) | 354 (46.8) | <0.001† | 227 (49.6) | 239 (52.2) | 0.428† |
| Smoking history (pack-years) | ||||||
| Mean±SD | 6.0±11.3 | 11.2±18.4 | <0.001‡ | 12.1±18.5 | 11.9±17.9 | 0.865‡ |
| Drinking quantity (cup/1 month) | ||||||
| Mean±SD | 33.6±65.0 | 28.7±75.6 | <0.001‡ | 33.8±72.5 | 37.7±86.9 | 0.461‡ |
| Diagnosis time (years) | ||||||
| Mean±SD | 9.3±7.5 | 8.4±6.9 | ||||
Table 2.
Effects of dental utilization according to diabetic status
|
Analysis method 1† |
Analysis method 2‡ |
||||||
|---|---|---|---|---|---|---|---|
| 2010 n (%) | 2011 n (%) | 2012 n (%) | Source | OR | 95% CI for OR2 | P-value | |
| Diabetic group (n=458) | 105 (22.9) | 130 (28.4) | 141 (30.8) | Diabetes Mellitus | 1.82 | 1.60-2.09 | <0.001 |
| (Yes vs No) | |||||||
| Normal group (n=458) | 78 (17.0) | 59 (12.9) | 84 (18.3) | Investigation year* | 1.10 | 1.05-1.15 | <0.001 |
| OR | 1.45 | 2.68 | 1.98 | ||||
| 95% CI for OR | 1.05-2.01 | 1.91-3.77 | 1.45-2.70 | ||||
| P-value | 0.026 | <0.001 | <0.001 | ||||
† Diabetes effects for dental outpatient utilization according to each year by simple logistic regression.
‡ Common estimate by generalized estimating equation(GEE) that is statistical analysis method of repeated measures for dichotomous categorical variables. Since DM×Year interaction term was not significant (P=0.150) therefore we removed it from the GEE model. *It was treated with order scale in the model.
Table 3.
Effects of dental utilization according to diabetic status by age groups
| Age (years) | Group |
Analysis method 1† |
Analysis method 2‡ |
|||||
|---|---|---|---|---|---|---|---|---|
| 2010 n (%) | 2011 n (%) | 2012 n (%) | Source | OR | 95% CI for OR | P-value | ||
| 20-49 | Diabetic (n=72) | 17 (23.6) | 15 (20.8) | 15 (20.8) | DM (Yes vs No) | 1.72 | 0.89-3.33 | 0.108 |
| Normal (n=72) | 11 (15.3) | 5 (6.9) | 14 (19.4) | Year* | 1.02 | 0.79-1.33 | 0.858 | |
| 50-59 | Diabetic (n=143) | 31 (21.7) | 47 (32.9) | 50 (35.0) | DM (Yes vs No) | 2.03 | 1.38-3.00 | <0.001 |
| Normal (n=143) | 28 (19.6) | 19 (13.3) | 28 (19.6) | Year* | 1.21 | 1.01-1.44 | 0.036 | |
| 60-69 | Diabetic (n=175) | 45 (25.7) | 49 (28.0) | 57 (32.6) | DM* (Yes vs No) | 1.76 | 1.23-2.50 | 0.002 |
| Normal (n=169) | 32 (18.9) | 28 (16.6) | 35 (20.7) | Year* | 1.13 | 0.96-1.33 | 0.144 | |
| ≥70 | Diabetic (n=68) | 12 (17.7) | 19 (27.9) | 19 (27.9) | DM* (Yes vs No) | 3.18 | 1.53-6.59 | 0.002 |
| Normal (n=74) | 7 (9.5) | 7 (9.5) | 7 (9.5) | Year* | 1.20 | 0.90-1.60 | 0.204 | |
† Diabetes effects for dental outpatient utilization according to each year by simple logistic regression.
‡ Common estimate by generalized estimating equation(GEE) that is statistical analysis method of repeated measures for dichotomous categorical variables. Since DM×Year interaction term was not significant (P=0.150) therefore we removed it from the GEE model. *Year: Investigation year and it was treated with order scale in the model.
Table 4.
Sensitivity analysis on diabetes effect for dental utilization by total samples set (n=5,108)
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