• Journal of Oral Medicine and Pain
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• 제30권2호
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• pp.257-268
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• 2005

우리나라 건강보험제도는 보수지불방식에서 전체적으로 보면 행위별수가제(fee for service)를 유지하고 있다. 이 제도에서는 진료수가의 설계에서 각 의료서비스의 단위를 설정하기 위해서는 현재 임상에서 이루어지고 있는 모든 의료행위에 대한 목록이 필요하게 된다. 따라서 본 연구에서는 측두하악장애 의료의 수가구조와 수가항목에 대해 재분류를 통한 체계화과정을 통해서 향후 투입자원에 기초한 상대가치를 산정하여 수가수준을 결정할 수 있는 준거를 제시하고자 하였다. 현행 행위별 수가제도의 범위내에서 측두하악장애 진료행위에 대한 델파이법을 이용하여 의료행위에 대한 재분류하여 항목화 작업을 거치면서 자원기준 상대가치 산출모델의 선행연구를 시행하였다. 이를 통해 의료행위분류에서는 총 151개의 의료 행위를 규명하였다. 이를 건강보험 수가항목이 되도록 하기 위해서는 지속적인 정련화 과정이 필요하게 되므로 용어의 정리 및 통일, 명확한 진료범위의 설명, 체계적인 분류구조 등이 고려되어야 한다. 이상의 연구결과는 향후 치과의료의 구조적 문제점과 현안과제를 해결하는 기초자료로 활용하고, 앞으로 치과의료의 수가 수준을 결정하는 후속연구의 방향설정과 참고자료로 활용하며, 의료수가체계의 표준화를 유도하여 의료이용의 편의성을 도모하고 의료정책에 대한 국민적 신뢰를 회복하여 측두하악관절장애 진료의 건강보험 확대적용 및 향후 민간 사보험 도입시 기초자료로 활용될 것으로 사료된다.

• 대한소아치과학회지
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• 제49권1호
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• pp.76-84
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• 2022

이 연구는 코로나 바이러스 감염증-19가 치과적 외상 환자 수에 미치는 영향을 분석하기 위해 수행됐다. 건강보험심사평가원의 보건의료빅데이터개방시스템에서 제공하는 자료를 기준으로 2010년부터 2020년까지 발생한 치과적 외상을 분석하였다. 코로나 바이러스 감염증-19 발생 이후 10만 명당 치과적 외상 발병률은 2017년부터 2019년까지의 평균 발병률에 비해 감소했다. 연령별로는 0 - 4세 5.4%(p = 0.017), 5 - 9세 30.3%(p < 0.001), 10 - 14세 39.5%(p < 0.001), 15 - 19세 14.5%(p = 0.002), 20 - 29세 1.3%, 40 - 49세 0.2%, 50 - 59세 2.7%, 60세 이상 1.2% 감소했으며 30 - 39세는 2.5% 증가했다. 월별 변화로는 코로나 바이러스 감염증-19 신규 확진자의 폭증을 전후로 치과적 외상 환자의 수도 급감했다. 코로나 바이러스 감염증-19 발생 이후 치과적 외상의 발병률은 20세 미만의 연령군에서 유의하게 감소했으나, 20세 이상의 연령군에서는 유의하게 감소하지 않았다.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.96-105
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• 2017

Purpose: The National Health Insurance Service-National Sample Cohort and medical checkup data from 2002 to 2013 were used to evaluate the association between periodontal surgery for the treatment of periodontitis (PSTP) and vasculogenic erectile dysfunction (VED). Methods: Bivariate and multivariate logistic regression analyses were applied to a longitudinal retrospective database to assess the association between PSTP and VED while adjusting for the potential confounding effects of sociodemographic factors (age, household income, insurance status, health status, residence area, and smoking status) and comorbidities (diabetes mellitus, angina pectoris, cerebral infarction, and myocardial infarction). Results: Among the 7,148 PSTP within the 268,296 recruited subjects, the overall prevalence of VED in PSTP was 1.43% (n=102). The bivariate analysis showed that VED was significantly related to PSTP (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.38-2.06; P<0.001), and this was confirmed in the multivariate analysis after adjusting for sociodemographic factors and comorbidities (OR, 1.29; 95% CI, 1.06-1.58; P=0.002). Conclusions: Subjects with a history of periodontal flap surgery had a significantly higher risk of VED, after adjusting for potential confounding factors. Further studies are required to identify the key mechanisms underlying the association between severe periodontal disease and VED.

• 대한치과의사협회지
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• 제55권5호
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• pp.339-350
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• 2017

The aim of the study was to analyze the distribution of dental filling materials for carious permanent teeth of school children in a city. The study was designed as time-serial study, using the data of the dental survey for children aged 8-, 10- and 12-year children living in Gimhae city. The samples were selected by stratified clusters sampling. The number of surveyed samples in depth-analysis for types of dental filling materials were 567 in 2009 and 331 in 2013, respectively. They had dental restorations on one or more teeth. The changing pattern of used dental filling materials was analyzed between 2009 and 2013. Statistical analysis was conducted according to variables related to dental filling material type; DMFT and DMFS index, number of fissure sealed teeth and surface and surveyed year. Amalgam filling rate decreased from 27.9% in 2009 to 18.8% in 2013, while filling rate of tooth-colored materials increased from 56.1% in 2009 and 68.9% in 2013. Amalgam filling rate was a negative correlation with filling rate of tooth-colored materials or gold and number of fissure sealed teeth and a positive correlation with DMFT index. Filling rate of tooth-colored materials was a negative correlation with filling rate of amalgam or gold and DMFT index and a positive correlation with number of fissure sealed teeth. The light-curing composite resin should be included in the reimbursement range of National Health Insurance to solve an inequity of dental health care services.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.145-151
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• 2018

Objectives: The purpose of this study was to interpret regional disparities in the number of teeth sealed with pit and fissure sealants, identify the factors that affect these disparities and find solutions for the same. Methods: Data were collected from the National Health Insurance Service and Korean statistical information service using metropolis-city-rural area dental health infrastructure variables, regional health behavior variables, and local finance-related variables. Results: In 2015, the number of teeth sealed with pit and fissure sealants per 100 people was higher in the metropolis or city than in the rural area. There was a positive correlation between the number of teeth sealed with pit and fissure sealants and the number of dentists, dental hygienists, dental institutions, standardization rate of subjective awareness of well-being, standardization rate of brushing after lunch, and the proportion of welfare budget in the general budget. There was a negative correlation with the annual standardization rate of health institution use, the standardization rate of unused medical services, and the local government's financial independence. According to the final model of the multiple regression analysis, while the impact of infrastructure on dentistry was not statistically significant, the statistical significance of standardization rate of brushing after lunch, the local government's financial independence, and the proportion of welfare budget in the general budget were maintained. Conclusions: To reduce regional disparities in the volume of use of pit and fissure sealants, it was concluded that it may be effective to select regions with a consideration of the level of regional economic power, implement separate and appropriate policies and projects, and improve the awareness in residents.

• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 대한치과기공학회지
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• 제36권4호
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• pp.267-275
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• 2014

Purpose: The purpose of this study is to analyze denture satisfaction by burdened cost types. Methods: All 588 subjects in Gyeongsangnam-do, Korea was surveyed randomly. The study was conducted for about 24 days from March 28th to April 20th, 2014. The objects who participated in the survey were offered self-report questionnaires for this study. Results: Satisfaction with Half Price of the National Health Insurance Support Denture patients appears the highest point of $2.98{\pm}0.22$, and The Governor Pledge Free Denture appears $2.90{\pm}0.17$ the lowest. Also Pay Denture appears $2.96{\pm}0.21$. Provincial authority regulated medical carelessness inefficiently and at all during the procedure, without having to pay the cost of individual. also provincial authority support low budget. This is the result from the lowest satisfaction of The Governor Pledge Free Denture patient. Conclusion: According to the survey results, The Governor Pledge Free Denture and The Total Pay Denture's satisfaction are higher than The National Health Insurance Support Denture. and The National Health Insurance Support Denture are more uncomfortable than pay denture to use.

• 대한치과보철학회지
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• 제56권4호
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• pp.287-294
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• 2018

목적: 60세 이상의 의치사용자를 대상으로 구강 건강 상태, 의치 사용 및 관리 실태를 파악하여 올바른 의치 사용과 관리 중요성의 대국민 홍보 및 인식 제고를 위한 기초 자료로 활용하는 것이다. 대상 및 방법: 의치사용자의 구강건강상태, 의치성 구내염 현황 및 의치관리상태에 대해 2017년 8월 21일부터 9월 8일까지 서울 및 4대 광역시(부산, 대구, 광주, 대전)에서 60세 이상 남녀 중 현재 의치(총의치, 국소의치)를 사용하고 있는 자를 500명을 대상으로 조사하였다. 연구는 각 항목들에 대해 개별 면접 조사를 시행하였으며, 사용된 조사 항목은 응답자의 특성 8문항, 틀니 사용 현황 및 불편 경험 6문항, 구강 건강 상태(의치성 구내염 여부) 12문항, 틀니 관리 현황 7문항으로 구성되었다. 결과: 연구대상 의치사용자 중 161명(32.2%)은 본인의 구강 상태가 건강한 편으로 인식하고 있었고, 111명(22.2%)은 보통이라고 인식하고 있었다. 의치성 구내염은 208명(41.6%)에서 인지하고 있었다. 의치건강보험제도에 대해서는 조사대상자의 26.2%(131명)만이 인지하고 있었으며, 조사대상자의 65.4%(327명)의 의치사용자가 잘못된 의치 관리 방법을 사용하고 있었다. 결론: 본 연구에 따르면 의치사용자의 많은 수가 구강건강, 의치관리 및 의치건강보험에 대한 올바른 인식이 부족함을 알 수 있다.

• 대한치과기공학회지
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• 제33권3호
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• pp.237-246
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• 2011

Purpose: This study investigates dental health and chewing ability of patients hospitalized in geriatric hospital, and compares the chewing ability for each factor that can be used as data for dental healthcare of senior citizens and basic data for denture insurance for the elderly. Methods: The 101 subjects of this study were selected from 178 patients hospitalized in a geriatric hospital located in Daegu Metropolitan City, excluding 77 patients who were being treated in the intensive care unit and who were unable to communicate. The chewing ability of the patients were measured using an evaluation scale based on foods consisting of 10 different hardnesses. Results: Patients with less than 21 teeth, those with dentures and patients who were less than satisfied with their dental conditions had difficulties in chewing hard food such as dried squid and radish kimchi, and the Chewing ability increased proportionally to the number of remaining teeth(p<0.001), appropriateness of the maxillary and mandibular dentures(p<0.005) and the level of dental satisfaction(p<0.001). Conclusion: This study is limited as the subjects were selected from a single hospital and the authors estimate that various studies will be necessary to investigate the Chewing ability of patients hospitalized in long-term hospitals. The subjects of this study did not receive any dental treatment while staying in the hospital and many of the subjects had bad fit denture or didn't have dentures or did not use dentures, although they have dentures, which calls for denture construction and prosthetics through dental treatment.

• 대한치과기공학회지
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• 제42권2호
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• pp.149-162
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• 2020

Purpose: The purpose of this study was to conduct a cost accounting of implant prosthesis according to the fabrication activities. Methods: In this study, the cost price of implant prosthesis fabrication activities was calculated by the bottom-up costing approach for material and labor cost and the top-down costing approach for expenses and other. Results: The total cost price was estimated to 220,000 ~ 310,000 won per one implant prosthesis. By product, the screw type was estimated to 220,000 ~ 230,000 won, and when the stent and tray were included, it was 260,000 ~ 270,000 won, which increased about 40,000 won. And, the cement type with more material and labor time was estimated to 250,000 ~ 260,000 won, and when the stent and tray were included, it was about 300,000 won. Conclusion: In terms of the fabrication cost ratio by items, it was shown that material cost and labor cost accounted for about 40% and 30% of the total cost structure for resin case, respectively, which was the opposite for porcelain. It was shown that expenses and general administrative expenses accounted for about 15%, and profits were about 11% ~ 14% in both cases.