임플란트와 스케일링 건강보험 급여화 정책에 따른 구강보건의료 이용 변화 = Changes of Oral Health Care Utilization Following National Health Insurance Coverage Expansion for Scaling and Dental Implants in Korea

다국어 초록 (Multilingual Abstract)

Purpose: This study examined changes in oral health care utilization following the
expansion of National Health Insurance coverage for scaling and dental implants in
Korea. By focusing on preventive and high-cost prosthetic services, the study aimed
to identify differential policy effects across service types and age groups, with
particular attention to utilization patterns, expenditure structure, unmet dental care
needs, and subjective oral health status.

Methods: Two nationally representative datasets were used. The Korea National
Health and Nutrition Examination Survey (2010–2023) was employed to analyze
population-level trends in dental service utilization, unmet dental care due to economic
reasons, and subjective oral health status. The Korea Health Panel Survey
(2010~2018) was used to examine detailed changes in dental visits and expenditure
components, including insurer payments, statutory copayments, and non-covered costs.
Price elasticity of demand for scaling and dental implants was estimated by linking
changes in real prices and utilization before and after policy implementation.

Results: Following insurance coverage expansion, scaling utilization increased
markedly; however, demand remained price-inelastic, indicating that preventive service
use was influenced more by health awareness and behavioral factors than by price
reduction. In contrast, dental implant coverage led to a substantial decline in
out-of-pocket prices and a sharp increase in utilization among older adults, with price
elasticity exceeding unity during the initial post-policy period. Over time, implant
utilization growth stabilized, suggesting a policy settling effect after the release of
suppressed demand. Dental expenditure analysis revealed that although total dental
spending increased due to expanded prosthetic treatment among older adults,
individual financial burden decreased through reduced statutory copayments and
non-covered expenses. Moreover, unmet dental care due to economic reasons
declined significantly, particularly among adults aged 65 years and older. Subjective
oral health status improved in older age groups, reflected by a decrease in negative
self-rated oral health and an increase in neutral assessments.

Conclusion: The expansion of insurance coverage for scaling and dental implants in
Korea resulted in heterogeneous policy effects by service type and age group.
Preventive services showed limited price responsiveness, while high-cost prosthetic
care demonstrated strong utilization responses to price reduction, especially among
older adults. Overall, the policy contributed to improved access to dental care,
reduced economic barriers, and favorable changes in oral health perception among the
elderly. These findings underscore the importance of service-specific and
age-sensitive approaches in designing future dental coverage policies.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구배경 및 필요성 1
• 2. 연구목적 4
• Ⅱ. 연구방법 5
• 1. 연구설계 5
• 2. 연구대상 5
• 3. 연구변수 7
• 4. 분석방법 8
• Ⅲ. 연구 결과 19
• 1. 대상자의 일반적 특성 19
• 2. 연도별 치과 이용 실태와 건강보험 치과 급여 정책 23
• 3. 스케일링과 임플란트 건강보험 급여화 정책으로 인한 의료 이용 추이와 수요에 대한 가격탄력도 27
• 4. 치과의료비 변화(한국의료패널) 33
• 5. 치과진료 미치료 여부와 미치료 이유 중 경제적 이유, 주관적 구강건강상태 변화
• (국민건강영양조사) 41
• Ⅳ. 고 찰 45
• Ⅴ. 요약 및 결론 55
• 참 고 문 헌 57
• 영 문 초 록 65