Domiciliary dental care coverage in Taiwan: An assessment of provider participation and geographic distribution using...

Universal health coverage (UHC) ensures access to needed health services without financial hardship. While Taiwan has achieved near-universal coverage for most medical services, domiciliary dental care (DDC) for people with mobility limitations remains poorly integrated into the UHC framework. This study assessed DDC coverage in Taiwan using the World Health Organization UHC framework.

Publicly available 2024 data were analyzed for dental institutions, practicing dentists, DDC providers, and long-term care populations across Taiwan's six National Health Insurance (NHI) regions and 22 administrative districts. Geographic distribution was examined using provider density metrics, Lorenz curves, and Gini coefficients.

Among 7560 dental institutions, only 102 (1.3 %) provided DDC services, while 163 of 16,690 dentists (1.0 %) participated. Of 892,117 people who required long-term care, 23,379 (2.6 %) received DDC services. DDC represented 3.1 % of special needs dental services budget utilization. Geographic distribution demonstrated excellent equity with Gini coefficients of 0.064-0.082 and Lorenz curves above the equality line, indicating pro-rural distribution. However, service provision varied substantially: three districts had zero coverage, regional participation ranged from 0.5 % to 4.1 %, and provider density ranged from 0.7 to 3.9 per 10,000 people requiring care.

Despite comprehensive financial protection and equitable geographic distribution, critically low provider participation creates severe supply constraints that prevent most people requiring long-term care from accessing domiciliary oral health services. Taiwan has achieved equity in DDC distribution but not adequacy of supply, revealing substantial gaps in UHC achievement for vulnerable populations.