• 제목/요약/키워드: health insurance of scaling

검색결과 44건 처리시간 0.026초

한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황 (THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA)

  • 권도윤;남옥형;김미선;최성철;김광철;최재영;이효설
    • 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.

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

  • 장용석;안용우;박준상;고명연
    • Journal of Oral Medicine and Pain
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    • 제30권2호
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    • pp.215-230
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    • 2005
  • 이 조사논문은 건강보험 중 구강요양급여의 청구 및 심사등과 관련하여 일선 개원치의들의 견해를 조사하고, 보험관련정책수립에 개원치의들의 의견을 적극 반영코자 하는데 그 의의를 두고 있다. 본 조사는 2004년 2월경에 부산광역시 경남일대에 개원하고 있는 1,465명의 개원치의를 대상으로 설문조사를 실시하여 이들 중에서 406명으로부터 답변을 얻었고, 그 내용은 아래와 같이 요약할 수 있다. 1. 청구업무와 관련된사항 : 보험청구의 담당은 대체로 치과위생사(간호조무사)와 치과의사의 직접청구방식이 많았다. 대행청구는 그 비중이 전체에서 20%미만을 차지했다. 2.보험강좌의 참여도 : 보험강좌에 대한 관심은 비교적 저조한 것으로 나타났다. 3.이의신청유무 : 보험청구에 관련한 이의신청 유무는 엇비슷하게 나타났다. 4. 건강보험 심사규정에 관한 개원치의들의 견해 : 현재의 진료비 심사규정 지침에 대한 개원치의들의 생각을 묻는 질문에 대한 응답으로는 "심사기준이 난해하고 부당한 삭감이 많은 것 같다"는 응답이 압도적으로 많았다. 5. 건강보험심사평가원과 관련한 사항 : 약 70%의 개원치의들은 건강보험심사평가원으로부터 자율지도라는 명분하에 이루어지는 대화방식에 불만을 표시했다. 6. 진료비 영수증 발급에 대한 개원치의들의 입장 : 약 70%의 개원치의들은 진료비 영수증 발급에 여려움을 겪고 있었다. 7. 건강보험 비급여 진료분야의 급여적용에 관한 사항 : 대다수의 개원치의들은 전악 스켈링처치와 치면열구전색처치 및 불소도포와 같은 예방치료에 대해서는 급여적용을 희망하였다. 노인틀니, 귀금속을 제외한 보철치료, 광중합레진치료 등에 관하여는 비급여적용을 희망하였다.

치과이용 장애인들의 구강보건 행동과 태도에 관한 연구 (A Study on Behavior and Attitude of Pediatric Handicaps in Dental Facilities)

  • 남상분;한양금
    • 치위생과학회지
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    • 제1권1호
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    • pp.39-45
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    • 2001
  • 1999년 9월 20일에서 10월 23일까지 서울 및 경기도 소재의 사회복지시설과 의료시설 6곳을 선정하여 설문조사를 실시하여 치과를 이용하는 장애아동의 구강보건 행동과 태도를 조사 분석한 결과는 다음과 같다. 1. 장애인들은 자신의 치아가 대체로 건강하지 않다가 49.7%로 높게 나타났다. 2. 장애인들의 양치횟수는 장애유형에 따른 차이가 통계적으로 유의하게 조사되었다 (p<0.05). 3. 장애인들은 scaling(치석제거)경험이 없는 경우가 56.7%로 높게 나타났다. 4. 장애인들은 치통이나 잇몸 출혈 경험이 58.9%로 높게 나타났다. 5. 구강보건교육에 참석하겠다는 장애인은 64.4%로 통계적으로 유의한 차이가 있었다 (p<0.05). 6. 치과이용빈도는 불규칙한 방문을 하는 경우가 65.1%로 정기적인 치과방문으로 구강을 관리하는 비율이 낮았다. 7. 의료보험카드는 41.6%가 의료보호카드를 소지하고 있었다. 8. 장애와 구강건강은 관계가 있다가 61.8%로 통계적으로 유의한 차이가 있었다 (p<0.05).

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국내 중국인 유학생의 구강건강관리행태에 따른 구강건강 삶의 질 (Oral health of Chinese students in Korea by behavior of oral care)

  • 심재숙;이미라;강윤미
    • 한국산학기술학회논문지
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    • 제17권2호
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    • pp.343-350
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    • 2016
  • 구강건강 삶의 질에 영향을 미치는 구강건강관리행태를 파악하여 중국인 유학생의 구강건강 삶의 질을 향상시키기 위한 방안을 마련하고자 전북 소재 대학교 중국인 유학생 236명을 대상으로 2013년 4월 2일부터 5월 9일 동안 자기기입식 설문조사를 실시한 결과 65.3%가 1년 이내 치과내원 경험이 없었으며, 82.6%가 1년 이내 치석제거를 받지 않았고, 68.2%가 구강보건교육을 받은 적이 없는 것으로 나타났다. 일반적 특성에 따른 OHIP-14는 학년, 건강보험 가입여부, 유학생활 만족도에서 유의한 차이가 있었고(p<0.05), 구강건강관리행태에 따른 OHIP-14는 주관적인 구강건강상태, 1년 이내 치과내원 경험과 치석제거 경험에서 유의한 차이가 있었다(p<0.05). 구강건강 삶의 질에 영향을 주는 요인으로는 주관적인 구강건강 상태와 1년 이내 치석제거 경험으로 나타났다(p<0.05). 중국인 유학생들의 구강건강 문제 발생 시 의료기관의 편리한 이용을 위해 자국어 번역 안내서 및 의료 전문 통역자의 배치와 대학 차원에서 학교구강보건실의 운영 및 구강건강증진을 위해 실질적으로 도움이 되는 구강보건교육이 요구된다.

Analysis of Needs for Clinical Dental Hygienist's Performances Using Borich Needs Assessment and the Locus for Focus Model

  • Yang-Keum Han;An-Na Yeo
    • 치위생과학회지
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    • 제23권1호
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    • pp.1-12
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    • 2023
  • Background: This study aimed to identify the present level and needs of clinical dental hygienists and to present the Borich needs assessment and the locus for focus model as integrated priorities. Methods: The participants of this study were dental hygienists working in dental clinics (hospitals). The final data of the 194 participants were analyzed using frequency analysis and a paired sample t-test. To analyze the need for clinical dental hygienists to perform work, the Borich priority determination formula was used. The x-y plane consisting of four quadrants was used to analyze the need using the locus for focus model, which helps to determine the priority while showing visual effects. Results: "Scaling" was the highest required level for clinical dental hygienists, and "panorama taking" was the highest present level. The priorities of educational needs were systematically and visually derived from dental hygienists who were currently working through the Borich needs assessment and the locus for focus model for each task performed in the clinical field. Through the priorities of these two models, a total of 13 items appeared in the common high-level area; "oral health care (disability)," "oral health care (systemic disease)," "applying a rubber dam," "professional mechanical tooth cleaning," "root planing," "taking vital signs," "medication counseling," "wire cutting," "removing cement after removing band/bracket," "delivering bracket," "preparing mini-screw implantation," "dental insurance claim," and "patient reception." Conclusion: Based on the results, the department of dental hygiene should maintain and improve the standardized clinical practice curriculum and clinical dental hygienists' practical skills and contribute to the realization of the legal scope of dental hygienists, reflecting the requirements of clinical fields.

노인의 구강건강 장애요인에 관한 연구 (A Study of Factors of Oral Health Diseases among the Elderly)

  • 안권숙;지민경
    • 한국치위생학회지
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    • 제8권3호
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    • pp.73-84
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    • 2008
  • This study conducted an interview questionnaire survey of 245 old people in some halls for the aged in the Daejeon Metropolitan City from June 1 to 31, 2008. on their attitudes toward and practice items for oral health, resulting in the following findings. 1. In terms of socio-demographic characteristics of the subjects, males females were 48.2% and 51.8% respectively, and in the educational level, no-education, elementary school graduation, middle school graduation, and high school graduation and higher were 27.8%, 33.9%, 26.5%, and 11.8%, respectively, showing the statistically significant difference (p=0.009). 2. In terms of attitudes toward oral health management by oral health care education, regarding questions of use of oral and dental hygiene products (p=0.016), experience in scaling, and whether or not they wear false teeth (p=0.018), a group having received the education rather than a group not having received it showed more positive oral health management attitudes, indicating the statistically significant difference. 3. In daily living inconvenience of acute oral health diseases according to oral health care education, acute oral diseases presents in a group with the education ($2.30{\pm}0.72$) lower than in a group without the education ($2.49{\pm}0.63$), indicating the statistically significant difference(p=0.031). 4. Factors of oral health diseases showed the significant relation with types of health insurance, subjective systemic health status, acute diseases and subjective oral health status (p<0.01), and the explanatory power or the final model was 38%. Accordingly it is thought that there is the indicated need for analyzing and grasping factors related to oral health diseases among the elderly through considering their attitudes toward and practice for oral health, and developing programs of enhancing the oral health of the elderly in order for them to change their attitudes and habits, and also reinforcing oral health care education for the elderly focused on making them perform oral health behaviors in a right way.

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노인성 전신질환 입원환자에서 치성감염 관리에 관한 임상적 연구 (A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE ADMISSION PATIENTS WITH AGE-RELELATED GERIATRIC DISEASES)

  • 유재하;최병호;한상권;정원균;노희진;장선옥;김종배;남기영;정재형;김병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.414-421
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    • 2004
  • This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

주요 출혈성 질환자에서 치성감염 관리에 관한 임상적 연구 (A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE PATIENTS WITH MAJOR BLEEDING DISORDERS)

  • 김종배;정원균;노희진;장선옥;유재하;한상권;정재형;김병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권5호
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    • pp.330-337
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    • 2003
  • This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

국내외 치과 의료수가 비교현황 : 한국, 일본, 독일, 미국을 중심으로 (Comparative study on Dental fees of Korea, Japan, Germany and United States)

  • 류재인;김철신;정세환;신보미
    • 대한치과의사협회지
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    • 제53권4호
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    • pp.266-274
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    • 2015
  • The price for health service are decided by very complicated process because many of factors are related with them. The RBRVS(resource-based relative value scale) were used to calculate the Korean health service fees including dental fees. This study aimed to compare dental fees of Korea with other countries, such as Japan, Germany, and the US for evaluating the adequacy. Dental fees were categorized as oral evaluation and imaging, dental treatment including restorative, periodontal, and surgical work, and preventive treatment and compared by each country. The official documents about dental fees were collected from Korea, Japan, Germany, and the US. Each fee was presented as their own currency at first. Then they were converted into Korean won (KRW) by applying the market exchange rates at a specific point of time. Finally the fees were adjusted by purchasing power parities (PPPs) which equalize the different currencies. In general, the level of Korean fees were markedly low compared to those of Japan, Germany, and the US. German fees were similar or higher than that of Japan, and the US. The Korean fees were lower than three other countries 1.2~4.1 times for oral evaluation and 2.2~7.3 times lower for panoramic radiography. The endodontic fees of Japan, Germany, and the US were higher 1.8~15.3 times and 4.0~35.9 times for the deciduous teeth extraction compared to the Korean. In Japan the prophylaxis was 3.2 times more priced than the Korean fee. Exceptionally, the fees for re-evaluation, amalgam filling, and scaling were lower priced in Japan than other countries. This study has limitations on the items in definition and contents of dental practices units which were not exactly comparable and differently determined by countries. However, this study is meaningful because it surveyed the price levels to compare four different countries and then applied PPPs adjustment. This finding can be used to develop the dental RBRVs of Korean national health insurance and will contribute to improving the payment systems of health care.

일부 성인의 치과진료비 부담에 따른 치과 건강보험 확대 및 민영치과보험 가입 의사 (Some Adults' Opinions about Private Dental Insurance and National Dental Insurance according to Stress of Dental Treatment Cost)

  • 김윤경;김은지;노수현;백은진;신민서;황수정
    • 치위생과학회지
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    • 제15권6호
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    • pp.703-711
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    • 2015
  • 본 연구는 편의 추출된 30대~50대 성인 남녀 266명을 대상으로 치과치료비 본인부담금 스트레스, 비급여 치과치료 건강보험 확대, 민영 치과단독의료보험 가입 의사를 설문조사하였다. 건강보험 비급여 본인부담금 스트레스가 급여 본인부담금 스트레스에 비해 높으며, 교정, 임플란트, 틀니, 보철, 비급여재료 치아우식증 치료 순으로 스트레스 수준이 높았다. 치과치료에 있어서 건강보험확대는 필요하며 필요 순으로는 비급여재료 치아우식증 치료, 보철, 교정 순이었다. 연령제한이 있는 급여항목에 대해서는 적절하다는 응답이 치석제거 57.1%, 틀니 23.3%, 임플란트 14.3%였다. 구강상태가 나쁘다고 응답한 대상자는 급여 본인부담금과 비급여 본인부담금 모두에서 스트레스 정도가 유의하게 높으며 보철, 치아교정에 대한 건강보험 확대요구가 유의하게 높았다. 민영의료보험 가입자 중 치과치료를 보장하는 대상자는 18.3%, 민영 치과단독의료보험에 가입한 가입자는 8.3%였으나, 민영 치과단독의료보험 가입의사는 68.4%였다. 일반적 특성에 따른 민영 치과단독의료보험 가입의사 차이는 나타나지 않았고, 치과치료비의 부담정도와 민영 치과단독의료보험 가입필요 정도의 상관분석 결과, 임플란트 0.408, 비급여 치아우식증 치료는 0.404, 틀니 0.394, 보철치료 0.375, 치아교정 0.313 순으로 나타났다. 따라서, 적기치료가 가능하도록 급여 치과치료 본인부담금에 대한 부담 감소를 위해 치과치료 건강보험 급여 확대, 민영 치과단독의료보험 개발과 이에 따른 정부의 감독이 필요할 것으로 생각되었다.