Perceived barriers in accessing dental care among patients attending dental institute using decision-making trial and evaluation laboratory method

Introduction: Utilization of dental service is a concept of expressing the extent of interaction between the service provider and the people for whom it is indented. However, one of the major issues in social welfare is the equitable provision of these services to the population. Aim: To determine the perceived barriers affecting access to the dental services in the dental institute. Materials and Methods: A cross-sectional survey was conducted in the dental institute during the month of February in the year 2014 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included the 364 subjects. The required data were collected using a specially designed and pretested questionnaire. The data were analyzed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA) and MATLAB 7.6.0. The mean, standard deviations were used to describe the data, and inferential statistics included one-way ANOVA and DEMATEL. Results: The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access dental services. Based on subjects′ responses to the questions, the cost (54.75% agreed or strongly agreed) was identified as the most important factor affecting the access to dental health care followed by dentist-patient relationship (48.57%), inconvenience (36.55%), fear (23.70%), and organization (14.02%). The difference was found to be statistically significant (P = 0.0001). When the hierarchy of the affecting and affected factors was calculated, based on the factor analysis by using DEMATEL method, the cost (R−J = 0.16) and organization (R−J = 1.15), were certain affecting determinant which influenced the access to dental services and inconvenience. Conclusion: The major barriers to oral health care utilization among our patients were cost, fear, and organization. Policymakers, administrators, and insurance organizations have a major role. Hence, the policies should be fair and equitable.