The 1995 National Health Insurance Law, which guaranteed residents of Israel universal access to a broad package of services, did not include dental care, except for care for a few specific groups that constitute a small part of the population. To improve access to dental health services (DHS) for children, it was decided in 2010 to implement a reform and to add dental care for children, initially to age 8, and from 2012 to age 12. In January 2016, eligibility was extended to age 14 and the Ministry of Health intends to extend eligibility to age 18 in the coming years.
The current study examined: patterns of utilization of DHS among all children and among specific subgroups; barriers preventing children from seeking treatment; and the public’s experience of these services. To this end, in 2013 Myers-JDC-Brookdale Institute conducted a telephone survey of a national sample of parents of children age 2-11, who were eligible for treatment through the public system, and of children age 12-16, who were not eligible at the time. As noted, since January 2016, ages 12-13 are also eligible for these services. The findings present a comprehensive picture of patterns of utilization of DHS for children in Israel since implementation of the reform.
The main findings include:
64% of the children age 2-11 had seen the dentist in the previous year.
The publicly funded clinics are the main treatment setting for children from all population strata. About 70% of the those age 2-11 who had seen the dentist in the previous year had been to these clinics.
The change in the law was particularly significant for Jewish children with low socioeconomic status (SES). These children make the most use of public DHS (85% of those who had gone to the dentist). The percentage of Arab children with low SES who utilize them was lower (67% of those who had seen the dentist).
In recognition of the importance of routine checkups, these have been included in the package and no co-payment is charged. Only 45% of the children age 2-11 have routine checkups. A particularly small proportion of Arab children go for routine checkups.
Children of medium and high SES had been to the dentist mainly for periodic routine checkups. Children with low SES had been mainly due to dental problems – in many cases urgent problems.
Many parents are unaware of the importance of starting to see the dentist at an early age and of going for routine checkups even when there is no dental problem.
The findings suggest several possible programmatic directions, including: Extending the reform to additional age groups; making the services more accessible to the Arab population, outreach to groups and individuals who do not utilize the services, and increasing activity to raise awareness of the importance of keeping healthy teeth and encouraging dental care.
The study findings have been presented at various forums of policymakers and professionals and at the conference of the Israel National Institute for Health Policy Research.
The study was funded by the Israel National Institute for Health Policy Research.
Citations in the professional and academic literature
Rosen, B., Waitzberg, R., & Merkur, S. (2015). Israel: Health system review.
Horev, T., & Avni, S. (2016). Strengthening the capacities of a national health authority in the effort to mitigate health inequity—the Israeli model. Israel journal of health policy research, 5(1), 19.
Natapov, L., Sasson, A., & Zusman, S. P. (2016). Does dental health of 6-year-olds reflect the reform of the Israeli dental care system?. Israel journal of health policy research, 5(1), 26.
Rosen, B., Waitzberg, R., & Merkur, S. (2015). Health systems in transition. Health, 17(6).
Shahrabani, S., Benzion, U., Machnes, Y., & Gal, A. (2015). The use of dental services for children: Implications of the 2010 dental reform in Israel. Health Policy, 119(2), 117-126.
Citing suggestion: Ashkenazi, Y., Yankellevich, A., Zusman, S & Natapov, L. (2016). Patterns of Utilization and Experiences of Children in Dental Care Following the Reform of Dental Care in Israel. RR-710-16. Myers-JDC-Brookdale Institute. (Hebrew)