Trends of dental service utilization and expenditure in Taiwan from 2000 to 2020.

Background: /purposeSince 1995, Taiwan's National Health Insurance (NHI) has offered a comprehensive dental coverage to over 99 % of the population. This study mainly analyzed the dental service utilization and expenditure trends by the gender, age, and service type and evaluated the resource allocation across different demographics from 2000 to 2020. Materials and methods: Nationwide NHI administrative data were used to assess the dental visit rates, average visits per user, and per capita expenditure by the gender, age, and 11 service categories for the years 2000, 2005, 2010, 2015, and 2020. The analysis accounted for the fluctuations in the point value within the global budget system and calculated the dental expenditure across the demographic groups and service types. Results: The dental visit rates increased across all demographics, with the most substantial growth in the 0-14 age group (37.0 % in 2000 to 66.9 % in 2020). However, the visit rates for the older adults remained low at 39.5 % in 2020. Although the per capita expenditure rose significantly, the disparities persisted, with lower spending for the 65+ age group (58.5 USD) compared to the children (64.6 USD) in 2020. Operative dentistry and endodontic treatment expenditures showed declines in spending share, while preventive care and periodontal treatment expenditures increased. Conclusion: While Taiwan has made progress in increasing the dental utilization, especially for the children, challenges remain in improving access for the older adults. Policy adjustments are needed to enhance the dental care according to the diverse oral health needs of the different age groups.