• Title/Summary/Keyword: Dental insurance

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The determinants of purchasing private health insurance among middle-aged and elderly Korean adults (중.고령자의 민간의료보험 가입 여부의 결정 요인)

  • Yoo, Ki-Bong;Cho, Woo-Hyun;Lee, Min-Jee;Kwon, Jeoung-A;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.17 no.3
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    • pp.23-36
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    • 2012
  • Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

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Factors of Influencing the Benefit Amount according to the National Health Insurance Coverage in Pit and Fissure Sealants (치면열구전색 급여화에 따른 수혜량에 영향을 미치는 요인)

  • Ahn, Eun-Suk;Hwang, Ji-Min
    • Journal of dental hygiene science
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    • v.15 no.6
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    • pp.768-774
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    • 2015
  • The purpose of this study was to grasp the benefits from pit and fissure sealants and to analyze the factors of influencing the benefit amount by using the raw data of the Korea National Health and Nutrition Examination Survey for 2007~2013 targeting the subjects aged from 6 years in full to 18 years. The analysis was used STATA 11.0. As a result of the analysis, the following conclusions were obtained. It rose up to 1.24 pieces after carrying out the national health insurance coverage from averagely 0.93 piece until the year in 2007~2009 (up to November) when is before enforcing the national health insurance coverage in the pit and fissure sealants. The benefits from pit and fissure sealants depending on general characteristics were surveyed to be higher in the higher income level, in the more subscription to health insurance and private insurance, and in the more toothbrushing frequency per day. The factors that have influence upon the benefits from pit and fissure sealants were shown to include whether or not to have the national health insurance coverage in the pit and fissure sealants, income level, health insurance type and private insurance subscription appearance, and one-day toothbrushing frequency. Synthesizing the results, a rise in the benefits from pit and fissure sealants is shown in 2010 based on December 2009 when the national health insurance coverage in the pit and fissure sealants was implemented, but is showing the tendency of declining again from 2011. To increase the benefits from pit and fissure sealants, it is thought that the schemes will need to be discussed such as reinforcing publicity on the national health insurance coverage in the pit and fissure sealants, expanding a support for low-income bracket, and differentiating the outpatient cost sharing according to socio-economic level.

Regional Difference of Chronic Periodontal Care Services in Korea (의료기관 종별 만성 치주염 진료의 지역 간 차이)

  • Yoon, Young-Ju;Lee, Kyeong-Soo;Kim, Chang-Suk;Kim, Chang-Yoon;Hwang, Tae-Yoon
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.5
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    • pp.899-905
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    • 2015
  • Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

Comparison of Factors Affecting Perceived and Objective Dental Needs

  • Ahn, Eunsuk;Han, Ji-Hyoung;Kim, Ki-Eun
    • Journal of dental hygiene science
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    • v.19 no.3
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    • pp.147-153
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    • 2019
  • Background: With increased interest in oral health, several efforts have been made to improve oral health conditions. To achieve this, needs for oral health must be precisely determined and accurately measured. Therefore, factors influencing both objective unmet dental needs, which were determined by experts, and perceived unmet dental needs, which were determined by patients, were examined in this study. Methods: Responses of 17,735 respondents aged greater than 19 years from the Korean National Health and Nutrition Survey collected using the fifth (2010~2012) rotation sample survey were analyzed. Based on the information collected from the survey and dental examination, we determined the associations between the independent (sex and socioeconomic level) and dependent variables using a chi-squared test. Moreover, ordinal logistic regression analyses on multiple categorical values were performed using perceived and objective dental needs as the dependent variables. Results: Generally, factors influencing both perceived and objective dental needs were similar. These included sex, household income, educational level, private insurance, and subjective oral health status. However, the high-income groups had lesser perceived and objective dental needs compared to the low-income groups. Furthermore, factors such as sex, educational level, and marital status had different influence on both needs. Conclusion: Generally, factors that affect perceived and objective dental needs were similar. To minimize unmet dental needs, factors influencing both perceived and objective dental needs should be examined for a broad dental insurance coverage, and efforts to prevent oral diseases are also required.

Analysis research about awareness of demanders of recuperation allowance for dental clinic health insurance in Daejun and Chunchung area (대전·충청지역 치과건강보험 요양급여비용 청구자의 인식도 분석조사)

  • Kim, Sung-Hee;Kim, Min-Ja;Nam, Yong-Ok
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.2
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    • pp.275-289
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    • 2011
  • Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.

Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study

  • Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.3-11
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    • 2018
  • Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. Results: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. Conclusions: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

Influences of Previous Pain Experiences during Dental Treatment on Dental Fear (과거 치과치료의 통증 경험이 치과공포에 미치는 영향)

  • Park, So-Young;Won, Young-Soon
    • The Korean Journal of Health Service Management
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    • v.6 no.1
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    • pp.141-151
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    • 2012
  • In this study a survey was conducted of a total of 187 insurance sales workers from 10 branches of S Insurance Company located around Korea to gather information on causes of dental fear. Results revealed that the group who had experienced direct dental pain in the past showed higher fear levels than the group without such experience. With respect to indirect dental pain, the group with such experience showed higher fear levels in 'fear of dental appointments' and 'fear of antiseptic smells than the group without such experience. Concerning gender, higher fear levels were observed among females than among males. It was also found that the majority of the respondents seldom go for a regular dental check-up regardless of whether they had experienced direct or indirect pain during dental treatment. In addition, there was positive correlation among all the items in the Dental Fear Survey Scale at a significance level of 0.1%. Twenty of all the DFS items were found to be related to causes of dental fear, meaning that most of the elements involving the dentistry may contribute to the development of dental fear among dentally fearful people.

Convergence study of long-term care insurance system for elderly of awareness of middle-aged people and demand for dental services in the system (한국 중년층의 노인장기요양보험제도에 대한 인식과 구강보건진료에 대한 요구의 융합 연구)

  • Park, Jeong-Ran;Youn, Mi-Sun;Choi, Yu-Ri
    • Journal of the Korea Convergence Society
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    • v.9 no.7
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    • pp.95-103
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    • 2018
  • The purpose of this study was to awareness of dental care services in the elderly long-term care insurance system and retirement preparation of middle-aged people. The survey respondents had a 56.1% saving for old age life, And showed a tendency to they don't like depend on one's family(41.8%), elderly care was intended to use facility services and nursing care. 36.7% of respondents answered "I know a little" about the system. Also, the need for dental care services within the system was high (98.5%), If the service is provided, 92.3% of the respondents said that they would participate, otherwise unrecognized rate of dental care services in long-term care insurance was 85.2%. Therefore, it is necessary to expand the awareness of the part of dental care service in the system. The results of this study can be used as basic data for the improvement of the system of dental care services in long-term care insurance for elderly.

Analysis of current nursing homes in Korea and to assess the role and prospect of dentists in comparison to Japanese long term care insurance system (한국노인요양시설 구강 위생 현황과 일본 노인요양보험법 비교를 통한 치과의사의 역할과 전망)

  • Shin, Ri-Hye;Bae, Hanna Eun-Kyong;Choi, Sung-Ho;Park, In-Im; Ohyama, Takashi;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.83-91
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    • 2008
  • Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

SUBSIDY ESTIMATION FOR INDUCING OPENING OF DENTAL HOSPITAL OR CLINIC FOR THE DISABLED (장애인 치과 병·의원 개원 유도를 위한 적절한 보조금 산정에 대한 연구)

  • Song, Changmok;Hyun, Hong-Keun;Shin, Teo Jeon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.55-65
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    • 2016
  • The objective of this study was to estimate the proper amount of subsidy required to operating dental hospital or clinic for the disabled. Models for estimating operating profit of general dental hospital/clinic and opportunity cost of operating dental hospital/clinic for the disabled was formulated. Data were collected from various sources such as the annual reports of Purme Hospital, one of the running dental hospitals for the disabled, statistics from Healthcare Bigdata Hub, operated by Health Insurance Review & Assessment Service of Korean Government, and the deliberation data of non-reimbursable treatments in Seoul Dental Hospital for the Disabled. A dental hospital/clinic for the disabled was less profitable than a general dental hospital/clinic, of which the reason is that the chair time for the average patient is longer. However, It was false that a dental hospital/clinic for the disabled scored less average insurance fee for a treatment. Disabled patients had more frequent prosthodontic treatments, which had a high average insurance fee. There were some groups of treatments that could yield higher profitability in a dental hospital/clinic for the disabled; recall checks, and periodontal treatments.