• Title/Summary/Keyword: Dental health insurance coverage

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Cost Analysis for Dentures Performed at Dental Clinics in Korea (치과의원 의사의 틀니진료 원가 분석)

  • Chung, Seol Hee;Lee, Hye Jin;Oh, Ju-yeon;Woo, Kyung suk;Kim, Han sang
    • Health Policy and Management
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    • v.25 no.2
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    • pp.107-117
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    • 2015
  • Background: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. Methods: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. Results: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. Conclusion: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.

Working knowledge of National Health Insurance in dental clinic: dental records and the receipt book (치과건강보험의 시작과 끝: 진료기록부와 수납대장)

  • Jin, Sang Bae
    • The Journal of the Korean dental association
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    • v.54 no.6
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    • pp.448-456
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    • 2016
  • Dental care is becoming more available on the NHI(National Health Insurance) in Korea. Especially, complete denture, partial denture, dental scaling, and dental implant has been applied by NHI from 2012 to 2014. Although, the entire nation is not eligible for the benefit now, the more dental coverage of NHI is extended, the more regulaition is tightened. Essential documents for proof of correctness of dental treatment covered by NHI are dental records and the receipt book. Summary of regal regulation about them is as follows 1. Chief complaints of patients, diagnosis, progress, and act of treatment, drugs and materials of treatment, doctor's sign, date and hour should be placed accurately on dental record 2. Dental clinic should collect patients sharing of the dental cost covered by NHI. 3. Dental clinic should keep the receipt as proof of purchase of dental drugs or materials.

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Affecting Factors on National Health Insurance Coverage Dental Scaling Experience (건강보험 치석제거 수진에 영향을 미치는 요인)

  • Heo, Yun-Min;Kim, Hyoung-Joo;Kim, Mi-Na;Lim, Hee Jung;Kim, Myoung-Hee;Lim, Do-Seon;Ahn, Yong-Soon
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.287-294
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    • 2015
  • The aim of the study was to investigate the affecting factors on National Health Insurance coverage dental scaling experience. The self-reported survey for the adults living in Seoul, Gyeonggi province and Incheon had been progressed from February 10, 2014, to February 28, 2014, after receiving informed consents. And the 238 survey results had been analysed as the data of this study. The data analysis such as frequency analysis, ${\chi}^2$-test, and multi-logistic regression (p<0.05) for all collected survey data had been processed using IBM SPSS Statistics ver. 20.0. According to multiple logistic regression analysis, regular dental check-up (odds ratio [OR], 2.63; confidence interval [CI], 1.05~6.59) and dental scaling experience (OR, 3.06; CI, 1.09~8.54), monthly income (OR, 3.55; CI, 1.01~12.56) were the factors having statistically significant influence. Therefore, in order to increase of National health insurance dental scaling experience, it is necessary to increase awareness of the new dental scaling system through the promotion and oral health education about national health insurance dental scaling, and to emphasize the importance of dental Scaling by regular dental check-up.

Analysis of Composite Resin Treatment Pattern Changes After the Insurance Coverage (급여화 이후 복합 레진 수복 치료 패턴 변화 분석)

  • Jo, Sangmi;Lee, Koeun;Nam, Okhyung;Lee, Hyo-seol;Choi, Sungchul;Kim, Kwangchul;Kim, Misun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.151-159
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    • 2021
  • Since January 2019, insurance coverage for caries treatment of permanent teeth using composite resin in children aged 12 and under has started in South Korea. The purpose of this study was to compare the pattern of permanent molar composite resin restoration aged 12 and under before and after the insurance coverage from January 2009 to March 2020 in the Department of Pediatric Dentistry at Kyung Hee University Dental Hospital at Gangdong. Since the insurance coverage was started in 2019, the frequency of permanent molar composite resin restoration aged 12 and under has increased more than twice. There was a significant change in frequency of resin restoration by shape of cavity comparing before and after the insurance coverage, whereas there was no significant difference in changes by patient age, gender and position of tooth. As accessibility to the permanent tooth composite resin restoration is increased by the insurance coverage, which shows a fair survival rate, it is expected that it could be able to secure oral health in the early permanent dentition aged 12 and under.

Studies on patient's perception and awareness of health insurance coverage for smoking cessation treatment in dentistry (치과내 금연치료 건강보험 적용에 관한 환자 인식도 및 의식 수준에 관한 연구)

  • Cho, In-Woo;Shin, Hyun-Seung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.3
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    • pp.195-202
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    • 2015
  • Purpose: Recently, smoking cessation treatment at dental clinic can be covered by national health insurance. The aim of this study is to evaluate the awareness on the health insurance coverage for smoking cessation treatment in dentistry. Materials and Methods: The survey was carried out on 100 new patients of the patients in Dankook Dental Hospital from March to April 2015. The Questionnaire consists of 18 items. Results: The results show that many of patients expect positive effects of the treatment but most of the respondents were not aware of the initiation of health insurance coverage smoking cessation treatment in dentistry. Conclusion: The government and ministry of health should pay more attention to the promotion of the smoking cessation treatment in dentistry.

An analysis of the perceptions of dental implant plans in the Korean national health insurance and the dental clinic selection criteria among elderly patients in Hongseong-gun, Chungcheongnam-do (충청남도 홍성군관내 노인환자의 치과 임플란트 보험수급 인식도와 치과진료기관 선정 요건에 관한 분석)

  • Han, Min Soo;Kwon, Eun Ja;Choi, Esther
    • Journal of Technologic Dentistry
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    • v.43 no.3
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    • pp.124-131
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    • 2021
  • Purpose: This study aimed to investigate the perception of dental implant insurance supply and demand for the elderly living in Hongseong-gun and Chungcheongnam-do, as well as the selection criteria regarding dental clinics for dental implant treatment to collect basic data for improving the oral health of the elderly population. Methods: Participants living in Hongseong-gun, Chungcheongnam-do who were at least 55 years old from November 2020 to March 2021 were included in this study. The chi-square test was performed to examine the age-specific perception of insurance-covered dental implants (p<0.05). Results: The age group that was the most interested in implants was the 70s age group, and the difference between this age group and the other age groups was statistically significant. Those in their 70's, 80's, and 90's or older paid about 600,000 won including dental implants covered by insurance, and there was a significant difference (p<0.05). Those in their 60s, 70s, and 80s estimated the highest value of implants covered by insurance as two and showed a significant difference (p<0.05). The awareness of the dental implant insurance by age showed that all age groups, except for the ≥90 years age group, considered the insurance to be mediocre mostly due to the large co-payment (p<0.05). Conclusion: There were differences by age in the awareness of dental implant insurance, co-payments, number of applications, and insurance coverage. The perceptions on dental implant insurance by age showed that all age groups except for those over 90 years and older, they considered the insurance was just mediocre the most.

Comparison of study affecting the use of dental sealant in consequence of its inclusion in the National Health Insurance coverage: Using data from the 5th-7th National Health and Nutrition Examination Survey(KNHANES) (치면열구전색 급여화에 따른 치면열구전색 수혜 비교 연구: 국민건강영양조사 제5기~7기 자료를 활용하여)

  • Kim, Mi-Jeong;Lim, Cha-Young;Son, Ju-Lee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.12
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    • pp.798-806
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    • 2020
  • Dental sealant is a procedure to prevent dental caries on the occlusal surface of healthy teeth. Raw data from the 6th-7th Korean National Health and Nutritional Examination Survey (KNHANES) were analyzed. This study was conducted to provide basic data which is necessary for the national health care project and for expanding the standards of coverage for the Dental sealant procedure. In this study, subjects were a total of 4,366 children from the age of 6 to 18 and surveyed for the Amount of Received Dental sealant and rate of Received Dental sealant. In 2012, the coverage rate for pit and fissure sealing procedures differed significantly in terms of age, residential area and average monthly income. This coverage varied as per average monthly income in 2014 and as per age and average monthly income in 2017 (P < 0.05). In 2014, average monthly income had a significant influence on the coverage rate, while age and average monthly income had a significant influence on it in 2017 (P < 0.05). These findings suggest that in order to increase the sealing procedure coverage, continuous promotion of dental sealant projects, reduction of copayments, inclusion of varied tooth types and age groups, expansion of coverage to isolated areas and inclusion of socially disadvantaged groups are necessary.

A study on the production environment of crown prosthesis for National Health Insurance benefit (건강보험 급여화 관련 크라운보철물 제작실태 연구)

  • Cho, Mi-Hyang;Lee, Hee-Kyung;Nam, Shin-Eun
    • Journal of Technologic Dentistry
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    • v.40 no.2
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    • pp.73-82
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    • 2018
  • Purpose: The purpose of this study was to investigate the production environment of crown prosthesis for National Health Insurance(NHI) benefit. Methods: This study carried out self-administered questionnaire survey from September 1, 2016 to October 31 by having research subjects as 261 dental technician. Except 100 copies with incomplete response, 161 copies were used as the materials of final analysis. Results: Unlike gold crowns, the material cost of metal crowns was paid at the dental laboratory(86.3%). Total material consumption for making metal crown was more than gold crown(63.4%), especially for the finishing and polishing processes(78.3%). The subjects responded that a routine dental laboratory fee of crown prosthesis is unreasonable, and it is necessary to adjust and improve it(metal crown 96.2%, gold crown 96.9%). NHI coverage dental prosthesis was not marked on the order form(46.0%), and the dental laboratory fee of that was nor received(64.0%). Conclusion : It is necessary to estimate the NHI cost level of the crown prosthesis by reflecting the production environment and engineering process in dental laboratories. In addition, institutional arrangement should be backed up so that dental laboratories can receive appropriate dental laboratory fee.

Changes in dental care access upon health care benefit expansion to include scaling

  • Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.405-414
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    • 2016
  • Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

Dentists' Opinions in The Dental Field of Present Health Insurance Claim and Review (건강보험중 구강요양급여의 청구 및 심사에 관한 치과의사의 견해)

  • Chang, Yong-Seog;Ahn, Yong-Woo;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.215-230
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    • 2005
  • The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.