Public Oral Healthcare Utilisation and Its Associated Factors in Malaysian Adults: A Time-Series Analysis (1992-2019)

Introduction and aims: Understanding the trend and associated factors are essential for enhancing equitable access to care, particularly given persistent disparities in healthcare utilisation across different population groups. This study examined the trend and factors associated with public oral healthcare services utilisation among adults in Malaysia over a 28-year period. Methods: Using trend analysis and a multiple linear regression framework applied to time-series data from 1992 to 2019, the study explored factors associated with public oral healthcare utilisation among Malaysian adults. The analysis was guided by Andersen's Behavioral Model, with secondary aggregated annual data obtained from the Health Information Management System, the Department of Statistics Malaysia, the Malaysian Dental Council, and the United Nations Food Balance Sheets. Variables were categorised into predisposing, enabling, and need-based factors. Results: The analysis revealed four distinct phases in utilisation: a period of decline (1992-1997), stabilisation (1997-2002), gradual growth (2002-2012), and sharp increase (2012-2019). Key associated factors of public oral healthcare utilisation among Malaysian adults included a negative association with higher household income, unemployment, relative poverty, and a positive association with internet access. Conclusion: These results highlight the influence of enabling factors such as socioeconomic and digital factors in shaping healthcare access. Targeted strategies must address structural and economic barriers while leveraging digital technologies to improve access and utilisation, essential for achieving equitable oral health outcomes in Malaysia.