Disparities in oral healthcare utilization among diabetic patients in Indonesia

Background: Indonesia’s National Health Insurance (NHI) system aims to ensure equitable healthcare access; however, significant oral health disparities persist among individuals with diabetes, a group vulnerable to systemic and oral health challenges. This study examines the influence of sociodemographic factors and oral health conditions on the utilization of dental care services in first-level healthcare facilities (FHF). Methods: Data from the Indonesia Healthcare and Social Security Agency in 2021, which included 14,242 visits to Family Health Clinics (FHF) by diabetics with oral and dental issues, were analyzed using logistic regression to reveal systemic inequities. Results: While 81.8% of patients received care from dental care providers (DCP), over 20% of diabetics outside Java-Bali sought care from non-dental providers. The key determinants included age, NHI membership type, diagnosis type, and geographic region. Elderly patients (≥55 years) were more likely to receive care from DCPs than younger individuals (aOR=1.42). Subsidized NHI members had a 0.77 lower probability of accessing DCP care, and patients outside Java-Bali were significantly less likely to use DCP services than those residing in Java-Bali (aOR=0.55). Conclusion: The findings revealed systemic gaps in oral healthcare access for diabetics, emphasizing the need for targeted policy interventions to address regional and demographic disparities and strengthen universal healthcare systems in Indonesia and other LMICs.