• Journal of Periodontal and Implant Science
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• 제48권5호
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• pp.317-325
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• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

• 치위생과학회지
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• 제15권3호
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• pp.287-294
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• 2015

연구 대상자의 건강보험 치석제거 수진에 영향을 미치는 요인을 알아 보기 위하여, 2014년 2월 10일부터 2014년 2월 28일까지 수도권(서울, 경기 인천)에 거주하는 만 20세 이상 60세 미만의 성인 238명을 대상으로 설문조사하여 다음과 같은 결론을 얻었다. 건강보험 치석제거에 대한 인식을 조사한 결과 제도에 대한 개선점은 연간횟수가, 건강보험 치석제거에 대한 인지도는 보통이다가 그리고 건강보험 치석제거 제도에 대한 지지도는 그렇다가 가장 많은 분포를 차지하였다. 건강보험 치석제거를 받지 않은 이유로는 시간이 없어서가 가장 많았다. 건강보험 치석제거 수진 의향은 여자가, 정기적 구강검진을 받는 경우, 구강보건교육 경험 이 있는 경우, 건강보험 치석제거 경험이 있는 경우에 유의미하게 높았다. 로지스틱 다중회귀분석결과, 건강보험 치석제거 수진에 영향을 미치는 요인은 소득 (OR, 3.55; p<0.05), 건강보험 치석제거 경험 (OR, 3.06; p<0.05), 정기적 구강검진 (OR, 2.63; p<0.05) 순으로 나타났다. 이상의 결과로 볼 때, 건강보험 치석제거의 수진율을 높이기 위해서는 건강보험 치석제거에 대한 홍보 및 구강보건교육을 통하여 새로운 제도의 인지도를 높이고, 정기적인 구강검진으로 건강보험 치석제거의 중요성을 강조할 필요가 있다.

• 한국치위생학회지
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• 제9권1호
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• pp.169-180
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• 2009

This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

• 대한치과의사협회지
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• 제51권5호
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• pp.265-273
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• 2013

The insurance payment plan for dental implants in Korea has been criticized because the payment priority has not been properly established, and the benefits are concentrated among middle-class citizens. In the current study, the relationship between the oral health condition and socioeconomic status of the elderly was analyzed using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study aims to determine the reason underlying the criticism of the insurance payment plan. The subjects were >65-year-old individuals in the 2010 and 2011 database of KNHANES. Data from 2,812 subjects were analyzed. The socioeconomic status was determined based on edentulousness, molar tooth loss, and presence of 28 teeth. According to the analysis, the average income was 1,560,000 won for edentulous elderly, 1,811,000 won for elderly who had lost molar teeth, and 1,896,000 won for elderly with 28 teeth (p<0.05). In addition, elderly with a low education level demonstrated a poor oral health condition (p<0.001). In conclusion, the insurance plan currently under examination is not properly designed for economically impoverished elderly because the plan only covers 50% of the costs and is limited to implantation of molar teeth only. This plan will not provide practical benefits to elderly with a poor socioeconomic status; therefore, the insurance payment plan needs to be improved so that the appropriate beneficiaries can be targeted.

• 대한치과기공학회지
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• 제40권2호
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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.

• 대한장애인치과학회지
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• 제14권1호
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• 한국치위생학회지
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• 제17권3호
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• pp.539-551
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• 2017

Objectives: The purpose of this study was to investigate the changes in factors on unmet dental scaling rate before and after the national health insurance. Methods: This study used the $2^{nd}$ data from the Community Health Survey. The study participants numbered 209,341 in 2011 and 219,517 in 2013.The average age was $51{\pm}17$ in 2011 and $52{\pm}17$ in 2013. Data were analyzed by descriptive statistics, chi -squared test and logistic regression using SPSS 23.0. Results: The scaling experienced rate of Korean adults has fallen by 3.5% from 66% to 69.5%. Logistic regression analysis showed that 2.7 times more 'people who were educated at elementary school level or lower' did not use dental scaling compared to higher educated children. Agriculture, forestry and fisheries workers did not use scaling at 2.0 times. Local residents with an income of less than one million won did not use 1.7times scaling. Local residents of 'no private insurance' did not use scaling at 1.5 times. In the case of the predisposing factors, the 20s had less than 1.8 times scaling compared to 50s. In the case of needs factor, local residents who experienced 'bad oral health status' and 'dental calculus' were treated scaling 1.3 times less compared to people with good oral health status and normal periodontal symptoms. Conclusions: In Korea, local residents are less frequently treated scaling due to enabling factors such as accessibility. In addition, predisposing factors such as age and sex, and oral health status and periodontal symptoms were related to not using the dental scaling. Therefore, the universality of health care services should be considered so that people who need periodontal care can use scaling.

• 한국병원경영학회지
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• 제17권3호
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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.

• 한국융합학회논문지
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• 제9권2호
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• pp.125-136
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• 2018

본 연구는 의료소비자를 대상으로 실시되고 있는 치과건강보험급여화의 인식도를 조사하여 미래 치석제거 국민들의 구강건강향상을 위해 치과건강보험급여가 확대되고자 하는데 목적이 있다. 연 1회 치석제거급여 연령에 대한 적절성 여부는 나이와 교육수준에서 유의한 차이가 있었고(p<0.05), 연 1회 치석제거 급여횟수에 대한 적절성 여부는 결혼여부, 지역(구), 자가구강건강인지에서 유의하였으며(p<0.05), 연 1회 치석제거 급여수가에 대한 적절성 여부에서는 하루잇솔질총횟수가 통계적으로 유의하였다(p<0.05). 결국 연령이 증가하면서 나타나는 치주질환의 증가로 국가 차원에서의 건강보험급여 항목이 추가되어야 하며, 본 연구결과에서와 같이 치석제거 건강보험급여화는 연령, 횟수, 수가부분에서 더욱 확대 되어야하며, 향후 치과건강보험 급여정책 향상을 위한 노력은 국민의 구강건강을 위해 계속되어야 한다.

• 보건행정학회지
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• 제25권2호
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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.