Background
Recent decades have seen an improvement in the dental health of the elderly population in Israel. However, its dental health level remains below the standards of many developed countries. Part of the explanation for that has to do with barriers to accessing dental care. In February 2019, Israel extended a policy reform in dental services, initiated in 2010, to the elderly, in order to improve their access to services and reduce some of the barriers. The implementation of the reform began by including preservative dentistry for senior citizens aged 75 and above in the basket of services provided under the National Health Insurance Law, and since October 2019, prosthetic care for citizens aged 80 and over is also included.
Objectives
- Examine the pattern of dental care utilization among the elderly over the first three years of the reform.
- Learn about the health plans’ preparation for providing dental services for senior citizens as part of the reform.
Method
- Secondary analysis of data on dental care to patients aged 75 and above provided by the health plans to the Ministry of Health in 2019-2021.
- Telephone interviews with key leading officials from all health plans who have been engaged in preparing for providing dental services in the reform framework.
Main Findings
The years 2019-2021 have seen a moderate increase in the rates of dental treatments and of senior citizens treated in the health plans’ dental clinics. A particularly sharp increase of 133% was recorded in the rate of first-aid recipients. A more moderate increase was documented in surgical treatments (22%), restorative treatments (9%), and preventative treatments (8%). From 2020-21, the rate of prosthetic treatments increased by 16%. At the same time, a minor decrease was recorded in the rate of dental imaging (-4%).
The findings pinpoint significant differences between the health funds in providing dental treatments to the elderly as part of the reform. Moreover, during the period prior to the reform, the health plans’ preparation has focused on training the doctors to provide dental care to the elderly. Nevertheless, no special organizational or infrastructural changes have been made, such as adding clinics or expanding existing clinics to serve this population.
Conclusions
A moderate increase was found in the rate of dental treatments provided to senior Israeli citizens over the first three years of the reform. Nevertheless, due to the COVID-19 pandemic that broke out in the course of this study, it is still premature to conclude as to the effects of the reform, and continued monitoring over a longer time span is required.
Policy Recommendations
- Further actions need to be taken to increase the awareness of the reform and highlight its advantages for the dental health of the entitled population.
- A follow-up study needs to monitor the trends identified in this study for another five years, with regard to the utilization of dental services by senior citizens, and their own perspectives regarding it.
Citing Suggestion: Berg-Warman, A., Kermel-Schiffman, I., Sadeh, S., Zusman, S.P., & Natapov, L. (2023). Health Plan Preparation for Policy Reform in Elder Dental Care. RR-938-23. Myers-JDC-Brookdale Institute. (Hebrew)