The role of socio-economic position on satisfaction with oral health services among South African adults : a structural equation model

Abstract

OBJECTIVE : To investigate how differences in socio-economic position (SEP) influence satisfaction with dental services among South Africans. METHODS : Data collected from a nationally representative sample of the South African population ≥16 years old (n=3,112) included socio-demographics, health insurance enrolment, past-year dental visit and facility type (public or private), satisfaction and reason(s) for dissatisfaction with the dental services received. Using structural equation modelling, a pathway to satisfaction with dental services was tested using a number of model fit statistics. RESULT : Of the 15.1% (n=540) who had visited a dentist in the past-year, 54.1% (n=312) were satisfied with the services received. Reasons for dissatisfaction included long waiting time (33.1%), painful procedure (13%) and rude staff (10.4%). Being of higher SEP was associated with reporting using private facility. Those who visited public facilities were more likely to have encountered a long waiting time, which in turn was associated with being more likely to report treatment as having been painful and reporting dissatisfaction. Long waiting times had the greatest direct effect on dental service dissatisfaction (β = -0.31). CONCLUSION : Improving waiting time is likely to be the major factor to help reduce socio-economic disparities in the quality of dental services experienced by South Africans.