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Factors influencing dental care services utilization in India using Andersen health behaviour model: a systematic
Sapna Negi1, Ankita Mathur1, Elakeya Udhaya1
1Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, 411018, India.
Background:
The use of dental services in India is impacted by a complex interplay of contextual, social, and individual factors. While healthcare systems often aim to promote equitable access to dental care, minimizing the impact of predisposing factors especially enabling resources remains a critical objective. Therefore, this study aims to identify the key factors influencing patterns of dental service utilization among the Indian population.
Methods:
This study included all qualitative, quantitative, and mixed-method research conducted in the Indian context that explored the factors influencing the utilization of dental care services. Three electronic databases (PubMed/Medline, Embase and Scopus) which stores the health sciences field related articles were searched. We applied Andersen health behaviour model to assess the dental services utilization. Joanna Briggs' tool of prevalence and qualitative assessment tool was used for quality appraisal of included studies.
Results:
From 1126 studies, results were drawn from final 15 studies. Sociodemographic characteristics, fear and anxiety, and a negative past experience were identified as predisposing factors. Income level, insurance coverage, and facility availability were found as enablers of dental service utilization. Perception of one's oral health status, and absence/presence of poor oral health symptoms were identified as need factors. Several contextual factors such as lack of accessible dental facilities, restricted availability of services in existing facilities and societal myths or misconceptions regarding oral health and facilities discourage people from seeking dental care. On quality appraisal, majority of the studies exhibited a low risk of bias, with only two showing moderate risk of bias.
Conclusion:
The application of Andersen model indicates disparities in dental service utilization in India. Targeted strategies that address both structural and behavioural barriers are essential to improve the reach and effectiveness of dental services in India.
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