CATASTROPHIC AND IMPOVERISHING DENTAL PAYMENTS IN GREECE: EVIDENCE FROM HOUSEHOLD BUDGET SURVEY DATA
Author(s)
Athanasios Chantzaras, PhD1, Ioannis John Yfantopoulos, II, DPhil2.
1Economics, University of Peloponessos, Athens, Greece, 2Professor of Health Economics, University of Athens, Ekali, Greece.
1Economics, University of Peloponessos, Athens, Greece, 2Professor of Health Economics, University of Athens, Ekali, Greece.
OBJECTIVES: Dental care in Greece is financed predominantly through out-of-pocket payments, with minimal public or statutory coverage. This study quantified catastrophic and impoverishing dental expenditure and examined its socioeconomic distribution.
METHODS: We analysed nationally representative Household Budget Survey (HBS) 2023 microdata from the Greek Statistical Authority at household level, accounting for the complex survey design. Catastrophic dental expenditure was defined as out-of-pocket dental payments exceeding 40% of household capacity to pay, calculated as total consumption minus a basic-needs line reflecting food, housing and utilities consumption. Impoverishment was assessed relative to the same basic-needs line. Survey-weighted descriptive estimates were produced overall and by consumption quintile and sociodemographic group. Independent associations were examined using survey-weighted Poisson regression, reporting incidence rate ratios with 95% confidence intervals (CI).
RESULTS: Catastrophic dental expenditure affected 2.21% of households (95% CI 1.68-2.75), corresponding to approximately 230,000 persons at the population level. The burden was steeply graded by consumption quintile: 9.06% of households in the lowest quintile experienced catastrophic dental payments, compared with 0.16% in the highest quintile. In multivariable Poisson regression (5,762 households; F=10.88; p<0.001), economic position was the dominant correlate, with catastrophic risk approximately 90-95% lower from the second consumption quintile upward. Impoverishing effects were also substantial: 7.43% of households were at risk of impoverishment, 0.20% were impoverished, and 1.49% experienced further impoverishment, corresponding to approximately 780,000, 21,000 and 155,000 persons, respectively. These effects were concentrated in the lowest consumption quintile, where 36.34% of households were at risk of impoverishment, 0,91% were impoverished, and 7.47% experienced further impoverishment.
CONCLUSIONS: In a setting of near-absent public dental coverage, out-of-pocket dental payments represent a measurable source of household financial hardship, concentrated among the lowest socioeconomic strata. The findings support strengthening financial protection for dental care, including targeted measures for vulnerable households.
METHODS: We analysed nationally representative Household Budget Survey (HBS) 2023 microdata from the Greek Statistical Authority at household level, accounting for the complex survey design. Catastrophic dental expenditure was defined as out-of-pocket dental payments exceeding 40% of household capacity to pay, calculated as total consumption minus a basic-needs line reflecting food, housing and utilities consumption. Impoverishment was assessed relative to the same basic-needs line. Survey-weighted descriptive estimates were produced overall and by consumption quintile and sociodemographic group. Independent associations were examined using survey-weighted Poisson regression, reporting incidence rate ratios with 95% confidence intervals (CI).
RESULTS: Catastrophic dental expenditure affected 2.21% of households (95% CI 1.68-2.75), corresponding to approximately 230,000 persons at the population level. The burden was steeply graded by consumption quintile: 9.06% of households in the lowest quintile experienced catastrophic dental payments, compared with 0.16% in the highest quintile. In multivariable Poisson regression (5,762 households; F=10.88; p<0.001), economic position was the dominant correlate, with catastrophic risk approximately 90-95% lower from the second consumption quintile upward. Impoverishing effects were also substantial: 7.43% of households were at risk of impoverishment, 0.20% were impoverished, and 1.49% experienced further impoverishment, corresponding to approximately 780,000, 21,000 and 155,000 persons, respectively. These effects were concentrated in the lowest consumption quintile, where 36.34% of households were at risk of impoverishment, 0,91% were impoverished, and 7.47% experienced further impoverishment.
CONCLUSIONS: In a setting of near-absent public dental coverage, out-of-pocket dental payments represent a measurable source of household financial hardship, concentrated among the lowest socioeconomic strata. The findings support strengthening financial protection for dental care, including targeted measures for vulnerable households.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR150
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Health Disparities & Equity
Disease
No Additional Disease & Conditions/Specialized Treatment Areas