Does subsidizing the cost of care impact on dental attendance patterns among older adults?

Objectives: To assess whether eligibility for an age-related universal (pioneer generation [PG]) subsidy incentivises dental attendance by older Singaporeans. Methods: Data were collected between 2018 and 2021 from in-person interviews of Singaporean adults aged 60–90 years using a questionnaire and a clinical examination. The questionnaire included details of age, gender, ethnicity, education, residential status, socio-economic status, marital status, eligibility for subsidy (community health assistance/CHAS, PG or both) and frequency of dental attendance. The clinical examination recorded number of teeth (categorized as edentulous, 1–9 teeth;10–19 teeth; ≥20 teeth). To estimate the effect of the PG subsidy on dental attendance pattern, a regression discontinuity (RD) analysis was applied using age as the assignment variable. Results: A total of 1172 participants aged 60–90 years (64.2% female) were recruited, with 498 (43%) being eligible for the PG subsidy. For those eligible for PG subsidy, there was a higher proportion of regular attenders than irregular attenders (53.6% vs. 46.4%). In age adjusted RD analysis, those eligible for the PG subsidy were 1.6 (95% CI: 1.0, 2.7) times more likely to report regular attendance than their PG non-eligible counterparts. The association remained strong (OR 2.1; 95% CI: 1.1–3.7) even after further controlling for demographics, socioeconomic factors, number of teeth and eligibility for the CHAS subsidy. Conclusions: Being eligible for the PG subsidy substantially increased the odds of regular dental attendance.