Evaluating Access to Dental Services in Primary Health Care Units: A Cross-Sectional Study of the Rotational Dentist Model in Rural Thailand
Abstract
Objective: To evaluate access to dental services and identify the associated factors following the implementation of a rotational dentist model in primary care units in rural Thailand.
Material and Methods: A cross-sectional study was conducted in seven Subdistrict Health Promoting Hospitals in Krasang District, Buriram Province. A total of 497 participants across six age groups were selected using proportional stratified random sampling. Data were collected through a validated questionnaire based on the five dimensions of access: availability, accessibility, accommodation, affordability, and acceptability. Chi-square tests and logistic regression identified predictors of service utilization.
Results: Most participants were female farmers with low household income and covered by the Universal Coverage Scheme. Overall, participants reported favorable access across all dimensions. Logistic regression showed that dental service utilization declined progressively with age, with utilization lowest among older adults ≥60 years (AOR=0.07; 95% CI: 0.02–0.23; p-value<0.001). Denture need was also positively associated with utilization (AOR=2.41; 95% CI: 1.30–4.47; p-value=0.005). Three access-related factors were strong predictors of utilization: awareness of service schedules (AOR=3.88; 95% CI: 2.40–6.28; p-value<0.001), awareness of basic services (AOR=9.50; 95% CI: 3.21–28.13; p-value<0.001), and ability to receive care without prior appointments (AOR=3.62; 95% CI: 1.96–6.69; p-value<0.001).
Conclusion: The rotational dentist model showed better access across multiple dimensions in primary care. However, disparities in access to dental services remain, particularly among older adults. Addressing these inequities requires enhanced service awareness and more flexible appointment systems. These findings can inform community-based oral health strategies and support the development of equitable policies in rural Thailand.
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