樱花视频

Skip to main content
Download PDF
  • Research
  • Published:

Association between type of health insurance and dental visits among Ecuadorian older population: evidence from a cross-sectional study

樱花视频 volume听25, Article听number:听94 (2025) Cite this article

Abstract

Background

Dental services are often overlooked within healthcare systems, despite their critical role in overall health. Socioeconomic barriers and disparities in insurance coverage frequently limit access to oral care, particularly among vulnerable populations like older adults.

Objective

To examine the impact of different health insurance types on the frequency of dental consultations among Ecuadorian senior citizens, aiming to highlight gaps in access to care.

Methods

Using the 2009 National Survey of Health, Well-being, and Aging (SABE), which aims to determine the health and living conditions of older individuals, this study analyzed the health insurance status and dental service visits of 4,565 older adults in Ecuador. Binary logistic regression was employed to explore the association between insurance type and dental-care utilization.

Results

In the sample, 76.50% of older adults had not visited a dentist in the past year. Insurance breakdown revealed 17.04% with general IESS, 9.59% with rural IESS, 2.23% with private insurance, 1.86% with ISSFA/ISSPOL, 1.86% with municipal insurance, and 69.66% were uninsured. Individuals with private insurance or ISSFA/ISSPOL insurance were 32% and 91% more likely, respectively, to seek oral care compared to those without these respective insurances. Conversely, uninsured individuals were 43% less likely to seek dental care than those with any type of insurance.

Conclusion

Health insurance significantly influences the frequency of dental consultations among Ecuadorian seniors, highlighting the need for policy interventions to ensure equitable access to oral care.

Peer Review reports

Introduction

Oral health is a crucial indicator of overall well-being, reflecting not only physical health but also quality of life [1]. The World Health Organization emphasizes that oral health is intrinsically linked to general health, and studies consistently highlight a strong association between improved oral health, broader insurance coverage, and higher utilization of dental services, particularly among higher-income groups [2,3,4,5,6]. Regular dental visits are essential for the early detection of diseases and the maintenance of oral health [15, 17]. However, access to oral healthcare should not be treated as a privilege tied to social class; rather, it should be recognized as a fundamental human right. There is a growing global consensus on the necessity of equitable access to quality oral health services, which underscores the importance of oral health in enabling individuals to achieve their full biological, psychological, social, and economic potential [7].

In Ecuador, the 2008 Constitution mandates the establishment of a universal, comprehensive, efficient, and high-quality health insurance system [8]. Healthcare provision is divided into public and private sectors. The public sector includes institutions such as the Ecuadorian Institute of Social Security (IESS-SSG), the Ministry of Public Health (MSP), and other agencies like the Ministry of Economic and Social Inclusion (MIES) and social security systems for specific groups, such as agricultural workers, the armed forces, and the police [8,9,10,11,12]. In contrast, the private sector, predominantly located in urban areas, caters to individuals with higher incomes and access to private insurance [13]. The MSP, as the largest healthcare provider, covers approximately 51% of the population, leaving about half of Ecuadorians reliant on alternative sources or without regular access to healthcare services [10, 14,15,16].

Although prior research has explored the connections between access to oral care, health insurance, and socioeconomic status, a significant research gap remains, particularly regarding how these factors interact to influence the frequency of dental visits. This study aims to investigate the impact of health insurance type, socioeconomic status, and demographic factors on the utilization of dental services among Ecuadorian seniors [12, 18, 19].

Globally, the aging population poses significant challenges to healthcare systems [20]. By 2030, the number of people aged 60 and older is expected to surpass the population of children under ten [21]. This demographic shift necessitates cost-effective healthcare interventions that can prevent illness and disability, thereby fostering healthy aging [20]. Ecuador is also experiencing a similar trend, with its population aging rapidly. This shift is already exerting pressure on the country鈥檚 healthcare system, economy, and social services. Consequently, the expanding senior population underscores the urgent need for policies tailored to address these demographic changes [22,23,24,25].

Given Ecuador鈥檚 aging population, it is critical to understand how access to oral healthcare interacts with insurance coverage. This study explores how different types of health insurance affect the frequency of dental consultations among Ecuadorian seniors, focusing on the roles of health insurance, socioeconomic status, and demographic factors to uncover the dynamics influencing oral health outcomes in the context of Ecuador鈥檚 demographic shifts. We hypothesize that Ecuadorian seniors with health insurance are more likely to attend regular dental consultations compared to those without insurance.

Materials and methods

Study design, setting and participants

This study employs a cross-sectional design using data from the 2009 National Health Well-Being and Aging Survey (SABE) conducted in Ecuador, which included questions related to oral health. Eligibility criteria included being aged 60 or older and residing in Ecuador. Data collection occurred throughout 2009, including 10,368 households, and resulted in 5235 participants. A probabilistic sampling method ensured the sample was representative of the national older population [26, 27]. The SABE survey included oversampling of individuals aged 80 and above to ensure adequate representation of this age group, given their distinct health and social needs. The study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, ensuring comprehensive and transparent reporting of the research methodology and findings.

Variables and measurement

Outcome variable: dental visits in the last year

The outcome variable assessed whether participants had visited a dentist in the last year. Response options included 鈥淣o鈥�, 鈥淵es鈥�, 鈥淒on鈥檛 know鈥�, and 鈥淒oesn鈥檛 answer鈥�. Fifteen observations with responses 鈥淒on鈥檛 know鈥� or 鈥淒oesn鈥檛 answer鈥� were excluded from the analysis, resulting in a final sample size of 5,220 participants.

Predictor variable type of health insurance

The predictor variable categorized participants based on their type of health insurance coverage. Options included:

  • IESS General (Ecuadorian Institute of Social Security general coverage).

  • IESS Farmer (specifically for agricultural workers).

  • Private insurance.

  • ISSFA/ISSPOL (Institute of Social Security of the Armed Forces and Police).

  • Municipal insurance.

  • None (no health insurance coverage).

Control variables

Control variables included in the analysis were:

  • Sex (Male/Female).

  • Age (60鈥�65, 66鈥�70, 71鈥�75, 75鈥�80, 81+).

  • Education (No education, Primary, Secondary, Postsecondary).

  • Self-reported ethnicity (Mixed, Black, White, Indigenous).

  • Married / Partnered (Never married or partnered, Married or partnered now or before).

  • Who do you live with? (Lives accompanied, Lives alone)

Sample size, missing data and bias

To ensure the reliability of the analysis, several measures were implemented to address potential sources of bias. Responses indicating 鈥淒on鈥檛 know鈥� or 鈥淒oesn鈥檛 answer鈥� were excluded from the analysis, and a probabilistic sampling method was employed to ensured that the sample accurately represented the national older population, thereby minimizing selection bias. The initial sample consisted of 5235 participants; however, after excluding cases with missing data, the final sample was reduced to 4565 participants. Specifically, 15 observations were excluded due to missing responses in the dental visit variable, 2 for the IESS general insurance variable, 1 for private insurance, 420 for age, 10 for education, and 222 for ethnic self-identification (670 subjects in total). These exclusions were necessary to ensure the completeness and reliability of the analysis.

Statistical methods

Descriptive analyses were conducted to summarize the characteristics of the study population, focusing on variables such as health insurance type, sex, age, education level, ethnic self-identification, marital status, and living situation. The outcome variable, whether participants had visited a dentist in the last year, was examined across these characteristics. To assess the relationship between health insurance type and the likelihood of visiting a dentist, logistic regression models were employed, adjusting for potential confounders including sex, age, education level, ethnic self-identification, marital status, and living situation. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported and model fit was evaluated with goodness-of-fit tests. All analyses were performed using StataMP version 17.0, with a significance level of p鈥�&濒迟;鈥�0.05.

Results

Descriptive results

Univariate and bivariate descriptive results

Table听1 shows the univariate descriptive statistics for the study population, with approximately 24.0% of participants reporting a dental visit in the last year, while the majority did not have health insurance. Among those with insurance, most were covered under general IESS and rural IESS, with smaller proportions holding private, ISSFA/ISSPOL, or municipal insurance. Females comprised slightly more than half of the sample, and about one-third of participants were aged between 60 and 65. The majority of participants had only primary education and identified as mixed ethnicity. Additionally, most were or had been married, and the vast majority lived accompanied. The bivariate descriptive analysis, also presented in Table听1, reveals that participants with private insurance or ISSFA/ISSPOL coverage were significantly more likely to visit a dentist compared to those without insurance; individuals with ISSFA/ISSPOL coverage were 2.4 times more likely to have a dental visit. Participants with higher education levels were also more likely to visit the dentist, as education promotes health-seeking behaviors. However, those from a mixed ethnic background or those living alone were less likely to seek dental care.

Table 1 Distribution of Dental visits in the last year by Health Insurance Type and Sociodemographic Characteristics (苍鈥�=鈥�4,565)
Full size table

Regression results

The multivariate logistic regression analysis (Table听2) included two models: Model 1, which contains only the insurance type variable, and Model 2, which includes all control variables. The analysis revealed that individuals with ISSFA/ISSPOL insurance were significantly more likely to visit a dentist, with odds ratios of 2.4 in Model 1 and 1.9 in Model 2, compared to those without that insurance. Conversely, participants with IESS Farmer insurance had lower odds of a dental visit, with odds ratios of 0.58 in Model 1 and 0.62 in Model 2, indicating barriers to care within this group. For participants with general IESS insurance, odds ratios (1.419 in Model 1 and 1.009 in Model 2) showed no substantial difference in dental visit likelihood compared to the uninsured, suggesting that general IESS coverage does not significantly influence dental care utilization. Model 2 demonstrated a better overall fit, evidenced by a higher Chi-Square Statistic in the Likelihood Ratio Test and a higher p-value in the Hosmer-Lemeshow Test, indicating no lack of fit. Both models performed better than a null model, with Model 2 showing stronger predictive ability than Model 1.

Table 2 Odds ratios (ORs) and 95% confidence intervals (CIs) from Logistic Regression models Predicting Dental visits in the Last Year
Full size table

Discussion

This study revealed a significant association between health insurance and dental visits, as only 29.0% of individuals who visited a dentist in the past year reporting any form of health insurance. Specifically, individuals with ISSFA or ISPOL health insurance were 2.4 times more likely to visit a dentist compared to those without insurance. This suggests that these groups, which typically enjoy greater job security and more comprehensive benefits, are more likely to utilize dental services. These results underscore the critical role insurance coverage plays in promoting access to healthcare services, including dental care. Conversely, individuals without insurance or with IESS Farmer insurance were less likely to visit a dentist, revealing significant gaps in coverage. This finding is consistent with Ju et al., who reported that 48% of individuals with the lowest educational attainment and income did not visit a dentist in the last 12 months [5]. Policies such as the Acuerdo Ministerial 1404, which mandates preventive health services for employees, may explain the higher utilization of dental services among those with ISSFA or ISPOL health insurance [28]. Additionally, cultural factors may play a significant role in the utilization of dental services. In countries with a longer history of including dental services within health insurance programs, individuals may demonstrate greater awareness and utilization of these services. However, in Ecuador, where dental services have only recently become more integrated into insurance offerings, utilization may be limited by lower public awareness and established health-seeking behaviors [29].

Despite these significant findings, some limitations should be considered. The cross-sectional nature of this study prevents the establishment of causality or tracking changes over time. Additionally, reliance on self-reported data introduces potential biases, such as recall bias or social desirability bias, where participants may inaccurately report the frequency of their dental visits. Excluding dependent older adults, who may face greater barriers to healthcare access, is another limitation. Furthermore, the identification of cognitive disturbances in participants posed challenges in this study. Despite these limitations, the probabilistic sampling method ensured that the sample was representative of the national older population, minimizing selection bias.

This study aligns with previous research by highlighting accessibility and affordability as key factors in healthcare utilization [30,31,32,33,34]. For instance, Srivastava et al.鈥檚 study in Australia reported a 43% increase in dental visits associated with insurance coverage [3]. While our findings highlight the challenges Ecuador faces in achieving equitable access to oral healthcare, they also underscore the importance of socioeconomic factors, such as age, education level, and ethnicity, in influencing access [5, 35,36,37]. Interestingly, our analysis revealed that having general IESS insurance did not increase the likelihood of visiting a dentist compared to having no insurance at all, indicating a critical distinction between coverage and actual usage. Programs like IESS, ISSFA, ISPOL, and IESS Farmer insurance may provide coverage for basic dental services, but barriers such as limited resources and poor communication about available benefits likely contribute to the lower utilization of these services.

Addressing these systematic barriers to oral healthcare will require targeted policy interventions. Public health insurance significantly impacts dental consultation rates, indicating the need for expanded coverage, especially among underserved populations. As L贸pez-Zevallos points out, lack of health insurance remains a major barrier to healthcare utilization [38]. Although Ecuador鈥檚 insured population increased from 26% in 2007 to 46% in 2013, this progress underscores the need for further improvements to ensure that all types of insurance provide adequate access to essential healthcare services, including dental care [39]. Policies should focus on not only expanding coverage but also improving resource allocation and communication to ensure that insured individuals are aware of and can access the services they are entitled to. These findings must be considered within the specific context of Ecuador鈥檚 health insurance framework. National health insurance structures differ globally, with accessibility and availability of services being partly shaped by each country鈥檚 health policies and the resources allocated to public and private healthcare systems. Ecuador鈥檚 particular policies, which prioritize coverage for the economically active population, may inherently limit access for certain groups, especially older adults who may not have consistent access to employer-based insurance.

The results from this study call for policies that prioritize equitable access to dental care for seniors, thereby improving their overall well-being within Ecuador鈥檚 evolving healthcare landscape [40]. Policymakers should consider implementing strategies that enhance the comprehensiveness and accessibility of dental care benefits across all insurance types. Additionally, public health campaigns aimed at raising awareness about the importance of regular dental visits and how to access these services could help mitigate some of the barriers identified. By addressing these issues, Ecuador can make significant progress towards ensuring that all citizens, regardless of their insurance status, have access to essential healthcare services [41].

Conclusion

This study investigates how health insurance coverage influences the likelihood of older adults in Ecuador visiting a dentist. The findings show that individuals with ISSFA and ISPOL insurance are more likely to utilize dental services, while those without insurance or with IESS Farmer insurance are significantly less likely to seek dental care. These results highlight the need for policies aimed at reducing disparities in dental care access among underserved populations.

Data availability

For this analysis, we used the 2009 Health, Well-being and Aging Survey (SABE) dataset. The survey was administered by the Census and Survey Institute in Ecuador (INEC). Interested researchers can access the public data by using its website: 鈥溾��. Other researchers could access the dataset in the same manner as the authors. The INEC required informed consent for all survey participants.

References

  1. World Health Organization. Achieving better oral health as part of the universal health coverage and noncommunicable disease agendas towards 2030. Rep Dir Gen. 2020.

  2. Vujicic M, Yarbrough C, Nasseh K. The effect of the Affordable Care Act鈥檚 expanded coverage policy on access to dental care. Med Care. 2014;52(8):715鈥�9.

    听 听 听

  3. Srivastava P, Chen G, Harris A. Oral health, dental insurance and dental service use in Australia. Health Econ. 2017;26(1):35鈥�53.

    听 听 听

  4. Wang Y, Wang J, Maitland E, Zhao Y, Nicholas S, Lu M. Growing old before growing rich: inequality in health service utilization among the mid-aged and elderly in Gansu and Zhejiang Provinces, China. 樱花视频 Health Serv Res. 2012;12(1):1鈥�11.

    听 CAS听 听

  5. Ju X, Do L, Brennan D, Luzzi L, Jamieson L. Inequality and inequity in the use of oral health services in Australian adults. JDR Clin Transl Res. 2022;7(4):389鈥�97.

    CAS听 听

  6. Lutfiyya MN, Gross AJ, Soffe B, Lipsky MS. Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12 months. 樱花视频 [Internet]. 2019 Mar 5 [cited 2023 Aug 14];19(1):265.

  7. Watt RG, Daly B, Allison P, Macpherson LM, Venturelli R, Listl S, et al. Ending the neglect of global oral health: time for radical action. Lancet. 2019;394(10194):261鈥�72.

    听 听 听

  8. Del Ecuador AC. Constituci贸n De La Rep煤blica Del Ecuador. Quito Trib Const Ecuad Regist Nro. 2008;449:79鈥�93.

    听

  9. Khalid H, Fox A. Public and Private Sector Health Facilities: Who Possesses National Health Guidelines? Available SSRN 3463280. 2019.

  10. Toro J, de LT, Rodr铆guez RC, S谩nchez FC. Normativa en seguridad y salud ocupacional en El Ecuador. Univ Soc. 2020;12(1):497鈥�503.

    听

  11. Investment in Health. Social and economic returns. Pan American Health Org; 2001. p. 315.

  12. Ministerio de Salud Publica. ACUERDO N掳 0091鈥�2017. 2017;(20):1鈥�106.

  13. Pan American Health Organization. Health system profile: Ecuador. Monitoring and analysis of the change and reform processes. 2008.

  14. Nasseh K, Vujicic M. The effect of growing income disparities on US adults鈥� dental care utilization. J Am Dent Assoc. 2014;145(5):435鈥�42.

    听 听 听

  15. Acu帽a C. Exclusi贸n en salud en pa铆ses de Am茅rica Latina Y El Caribe. Acta Bioethica. 2003;9(2):253鈥�253.

    听 听

  16. Lucio R, Villacr茅s N, Henr铆quez R. Sistema de salud de Ecuador. Salud P煤blica M茅xico [Internet]. 2011 Jan [cited 2023 Aug 15];53:s177鈥�87.

  17. Wall T, Guay A. The per-patient cost of dental care, 2013: a look under the hood. Health Policy Inst Res Brief Am Dent Assoc March. 2016.

  18. Zivkovic N, Aldossri M, Gomaa N, Farmer JW, Singhal S, Qui帽onez C, et al. Providing dental insurance can positively impact oral health outcomes in Ontario. 樱花视频 Health Serv Res. 2020;20(1):1鈥�9.

    听 听

  19. Manski R, Cooper P. Dental care use: does dental insurance truly make a difference in the US? Community Dent Health. 2007;24(4):205鈥�12.

    CAS听 听 听

  20. Patel J, Wallace J, Doshi M, Gadanya M, Yahya IB, Roseman J et al. Oral health for healthy ageing. Lancet Healthy Longev [Internet]. 2021 Aug 1 [cited 2023 Aug 14];2(8):e521鈥�7.

  21. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing. 2017: Highlights (ST/ESA/SER.A/397) [Internet]. United Nations; 2017.

  22. Rivadeneira MF, Mendieta MJ, Villavicencio J, Caicedo-Gallardo J, Buend铆a P. A multidimensional model of healthy ageing: proposal and evaluation of determinants based on a population survey in Ecuador. 樱花视频 Geriatr [Internet]. 2021 Nov 1 [cited 2023 Aug 14];21(1):615.

  23. Germ谩n Borda M, Castelllanos-Perrilla N, Pati帽o JA, Castelblanco S, Cano CA, Chavarro-Carvajal D, et al. Edentulism and its relationship with self-rated health: secondary analysis of the SABE Ecuador 2009 study. Acta Odontol Latinoam. 2017;30(2):83鈥�9.

    听

  24. Pengpid S, Peltzer K, Prevalence. and associated factors of self-rated oral health among a national population-based sample of adults in Ecuador: Results of the 2018 STEPS survey. J Int Oral Health [Internet]. 2021 [cited 2023 Aug 14];13(2):122鈥�8.

  25. Rosado JA, S谩nchez MIA. From Population Age Structure and Savings Rate to Economic Growth: Evidence from Ecuador. Int J Econ Financ Issues [Internet]. 2017 Sep 1 [cited 2023 Aug 14];7(3):352鈥�61.

  26. Instituto Nacional de Estad铆stica y Censos (INEC). Secretar铆a Nacional de Planificaci贸n y Desarrollo (SENPLADES). Archivo Nacional de Datos y Metadatos Estad铆sticos. 2009 [cited 2023 Jul 5]. ECUADOR - Encuesta de Salud, Bienestar y Envejecimiento 2009.

  27. Direcci贸n. de Producci贸n de Estad铆sticas Demogr谩ficas. Manual de Encuestador: Encuesta de Salud, Bienestar y Envejecimiento (SABE). 2009.

  28. ACUERDO 1404: REGLAMENTO PARA EL FUNCIONAMIENTO DE LOS SERVICIOS M脡DICOS DE EMPRESAS [Internet]. [cited 2024 Apr 20].

  29. Iza Cunalata AE. Nivel de satisfacci贸n de los pacientes que reciben atenci贸n en el 谩rea de odontolog铆a del Centro de Salud Tipo C Lasso. [Internet] [bachelorThesis]. Quito: UCE; 2022 [cited 2023 Aug 15].

  30. Cuasapas Benavides AH. Enfermedad periodontal en el adulto mayor adscrito a la unidad de atenci贸n ambulatoria del IESS Atuntaqui mejoramiento de la enfermedad periodontal mediante la aplicaci贸n de actividades odontol贸gicas preventivas en el per铆odo entre noviembre 2011 y febrero 2012 [Internet] [bachelorThesis]. Quito: USFQ, 2016; 2012 [cited 2023 Aug 15].

  31. Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: a quasi-experimental study. Ann Intern Med. 2016;164(12):795鈥�803.

    听 听 听 听

  32. Taylor H, Holmes AM, Blackburn J. Prevalence of and factors associated with unmet dental need among the US adult population in 2016. Community Dent Oral Epidemiol. 2021;49(4):346鈥�53.

    听 听 听

  33. Bendall D, Asubonteng P. The effect of dental insurance on the demand for dental services in the USA: a review. J Manag Med. 1995;9(6):55-68.

  34. Eslamipour F, Heydari K, Ghaiour M, Salehi H. Access to dental care among 15鈥�64 year old people. J Educ Health Promot. 2018;7.

  35. Guaraca LHS, Flores TRS. Efectos De La afiliaci贸n Al Seguro Social General en El Gasto De Bolsillo en Salud De Los hogares. Ecuador 2014. Rev Fac Cienc M茅dicas Univ Cuenca. 2020;38(1):33鈥�42.

    听 听

  36. Sommers BD, Gunja MZ, Finegold K, Musco T. Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA. 2015;314(4):366鈥�74.

    听 CAS听 听 听

  37. Amu H, Dickson KS, Kumi-Kyereme A, Darteh EKM. Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: evidence from demographic and health surveys. PLoS ONE. 2018;13(8):e0201833.

    听 听 听 听

  38. Gao XL, McGrath C. A review on the oral health impacts of acculturation. J Immigr Minor Health. 2011;13:202鈥�13.

    听 听 听

  39. L贸pez-Cevallos DF, Chi C. Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis. 樱花视频 Health Serv Res [Internet]. 2010 Mar 12 [cited 2023 Aug 15];10(1):64.

  40. Malo-Serrano M, Malo-Corral N. Reforma de salud en Ecuador: nunca m谩s el derecho a la salud como un privilegio. Rev Peru Med Exp Salud P煤blica [Internet]. 2014 Dec 2 [cited 2023 Aug 15];31(4).

  41. Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in Canada. J Can Dent Assoc. 2007;73(1):57.

    听 听

Funding

The authors received no external funding.

Author information

Authors and Affiliations

  1. Facultad de Ciencias de la Salud, Universidad Esp铆ritu Santo, Samborondon, Guayaquil, Ecuador

    Marite Falquez,听Adriana Canessa-Rojas,听Antonio Lanata-Flores,听Ivan Cherrez-Ojeda听&听Karla Robles-Velasco

  2. Facultad de Investigaci贸n, Universidad Estatal de Milagro, Milagro, Ecuador

    Freddy Espinoza-Carrasco听&听Marco Faytong-Haro

  3. Respiralab Research Group, Guayaquil, Ecuador

    Ivan Cherrez-Ojeda听&听Karla Robles-Velasco

  4. Ecuadorian Development Research Lab, Daule, Ecuador

    Marco Faytong-Haro

  5. Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Centro de Investigaci贸n en Salud P煤blica y Epidemiolog铆a Cl铆nica (CISPEC), Quito, Ecuador

    Claudia Reytor-Gonz谩lez听&听Daniel Simancas-Racines

Authors
  1. Marite Falquez

    You can also search for this author in 听

  2. Adriana Canessa-Rojas

    You can also search for this author in 听

  3. Antonio Lanata-Flores

    You can also search for this author in 听

  4. Freddy Espinoza-Carrasco

    You can also search for this author in 听

  5. Ivan Cherrez-Ojeda

    You can also search for this author in 听

  6. Karla Robles-Velasco

    You can also search for this author in 听

  7. Marco Faytong-Haro

    You can also search for this author in 听

  8. Claudia Reytor-Gonz谩lez

    You can also search for this author in 听

  9. Daniel Simancas-Racines

    You can also search for this author in 听

Contributions

Writing - Original Draft: Marite Falquez, Adriana Canessa-Rojas Writing - Review & Editing: Marite Falquez, Adriana Canessa-Rojas, Antonio Lanata-Flores, Ivan Cherrez-Ojeda, Marco Faytong-Haro, Karla Robles-Velasco, Freddy Espinoza, Claudia Reytor-Gonz谩lez, Daniel Simancas-RacinesResources: Antonio Lanata-Flores, Freddy Espinoza, Ivan Cherrez-Ojeda, Karla Robles-Velasco, Claudia Reytor-Gonz谩lez, Daniel Simancas-RacinesSupervision: Marco Faytong-Haro, Antonio Lanata-Flores, Freddy Espinoza, Ivan Cherrez-Ojeda, Karla Robles-Velasco.

Corresponding authors

Correspondence to Marco Faytong-Haro or Daniel Simancas-Racines.

Ethics declarations

Institutional review board statement

According to Article 43, Letter b of the regulation for the approval and monitoring of the ethics committee of human beings of Ecuador, investigations using open or public data are considered risk free. Nevertheless, we evaluated the necessity of IRB (Institutional Review Board) approval according to the UEES Institutional Review Board guidelines. According to their guidelines, as there was no direct interaction with human subjects and the dataset was available in the public domain, this project did not require IRB approval.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher鈥檚 note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article鈥檚 Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article鈥檚 Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit .

About this article

Cite this article

Falquez, M., Canessa-Rojas, A., Lanata-Flores, A. et al. Association between type of health insurance and dental visits among Ecuadorian older population: evidence from a cross-sectional study. 樱花视频 25, 94 (2025). https://doi.org/10.1186/s12889-024-20800-6

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-024-20800-6

Keywords

樱花视频

ISSN: 1471-2458

Contact us