Geographical Accessibility and Dental Service Cost in Client-Centered Perspective under Universal Health Coverage Between Community Medical Units and the Dental Clinic at Hatyai Hospital
Abstract
Objective: This study aimed to examine the geographical accessibility and cost in client-centered perspective associated with dental services at Community Medical Units (CMUs) and dental clinics at Hatyai Hospital, Thailand.
Material and Methods: A total of 380 dental patients from three CMUs under Hatyai Hospital were included, with proportional sampling based on patient volume at each unit. Data on service-related costs, travel distance, and transportation modes were collected using a structured questionnaire. Client costs were assessed for non-medical out-of-pocket expenses (transportation, food, lost wages), as all patients were covered under the Universal Coverage Scheme and did not incur medical treatment costs. Descriptive statistics and analysis of variance (ANOVA) were applied for data analysis.
Results: The findings revealed statistically significant differences in both travel distance and travel time among the three CMUs. Patients from CMU3 had the longest median [Interquartile Range (IQR)] distance of 15.0 (5.8) kilometers (KM). Motorcycles were the predominant mode of transportation, although automobile use increased from 20.3% to 39.2% during hospital visits. While median (IQR) total costs of CMUs were not significantly different from those at the hospital, visits to the hospital incurred significantly higher out-of-pocket costs (p-value<0.001). The median (IQR) of total client costs was 46.2 (117.4), 39.5 (117.6), and 37.5 (101.5) THB for CMU1-3.
Conclusion: The main cost components were transportation, food/snacks, and lost income due to the time spent receiving care. These findings underscore the impact of geographical access on service utilization and the economic burden on dental patients in semi-urban settings.
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