Universal coverage but unequal access: An area-level statistical and policy analysis of Taiwan's dental workforce

Universal health insurance coverage does not necessarily ensure equitable access to dental care. This study examined Taiwan's dental workforce distribution using area-level statistical analysis and interpreted the findings through an oral health equity perspective.

Publicly available county/city-level data on practicing dentists in Taiwan were analyzed. Dentist density was calculated as dentists per 10,000 population. Geographic variation was assessed using descriptive statistics, z-scores, quartile classification, highest-to-lowest ratio, coefficient of variation, and population-weighted Gini coefficient. Group differences were compared by geographic classification using Welch's t-test, Mann -Whitney U test, Hedges' g, and Cliff's delta. Findings were further mapped to global oral health equity priorities.

Taiwan had 16,690 practicing dentists, corresponding to 7.15 dentists per 10,000 population. County-level dentist density ranged from 14.69 in Taipei City to 1.36 in Kinmen County, with a highest-to-lowest ratio of 10.80, coefficient of variation of 0.54, and population-weighted Gini coefficient of 0.21. Six municipalities and city-level areas had significantly higher dentist density than non-six-municipality and county-level areas, respectively. Eastern and offshore areas had significantly lower density than other areas. Public data also showed 157 dental resource-underserved areas and 55 townships or districts without practicing dentists.

Taiwan's dental workforce challenge is not merely total supply but geographic inequity. Universal coverage may coexist with unequal access, highlighting the need for equity-oriented workforce planning and oral health monitoring.