‘문재인케어’와 영국의 치과의료제도

전지은(Ji-Eun Jeon),류재인(Jae-In Ryu) 대한치과보험학회 2017 대한치과보험학회지 Vol.7 No.1

The public and the organizations related with medical and dental care payed high attention for the Moon Jae-in Care announced at August 9th 2017. The Moon Jae-in Government presented that they will cover all the necessary medical expense by National Health Insurance(NHI). The first step is to get rid of the non-covered items, such as listed in NHI as necessary but non-covered and limited number of permission even though they are essential. In dental care, the percentage of out-of-pocket payment for dentures and implants decreased from 50 to 30. The resin for children and adolescent will be covered by NHI since 2018. This study aims to deal with the critical issues, for example three ‘low’s of payment-fees-coverage, proper health care delivery system, and possibility to extend the coverage by selected or preliminary lists. Also the change of National Health Service(NHS) in U.K. during recent decades will be researched. In conclusion, it is necessary to extend the coverage with patient-centered delivery system. Primary preventive approach needs to apply based on the clinical leadership by the professionals.health insurance coverage.

서울시 일부 이동노동자의 의치필요도와 연관된 요인에 관한 연구

류재인 ( Jae-in Ryu ),차은경 ( Eun-gyeong Cha ) 대한예방치과·구강보건학회 2023 大韓口腔保健學會誌 Vol.47 No.2

Objectives: Due to the prolonged coronavirus disease 2019 pandemic, prioritizing the safety and well-being of essential workers, who play a vital role in enabling contactless living, is paramount. This study aims to check oral health status and related factors in platform workers. Methods: The participants, who are platform workers in Seoul, were divided into three occupations: replacement driver, parcel, and delivery. The survey included oral examination and health-related questionnaires from August to November 2022. Finally, 204 platform workers in Seoul participated in the study. The socio-demographic characteristics of participants, such as sex, age, education level, and health behavior, were analyzed. A chi-square test and logistic regression analysis were performed to investigate the socio-demographic factors related to the need for dentures. Results: Most participants were men (97.5%), and in the age of 50s (33.8%). In total, the proportion of the need for dentures was 40.2%. It was high in the group of parcel, the 50s age group, and people without experience of the oral exam last year (P<0.05). The probability of needing dentures was 9.7 times higher in the 50s than in the 30s, and 2.3 times higher in the group without oral exam experience last year than the group with that experience. Conclusions: Among the platform workers in Seoul, age and oral examination were related factors for denture needs. To promote the oral health of platform workers, the policy to increase oral examination should be implemented.

영국 NHS의 치과의료보장 개혁 동향

류재인 ( Jae-in Ryu ),정세환 ( Se-hwan Jung ) 대한예방치과·구강보건학회 2017 大韓口腔保健學會誌 Vol.41 No.2

Objectives: Since 2000, the National Health Service (NHS) in the United Kingdom (UK) has challenged for a large-scale reforms. This study aims to review those reforms to reflect in the dental care system in Korea. Methods: Reports and papers that were published from 2000 to 2015 and were related to the NHS dental care system and reforms were searched. Among them, official reports from the government or organization were prioritized. Results: In 2002, the “NHS Dentistry: Options for Change” report suggested rebuilding the structure to meet the standard of care, improving the remuneration system, and modernizing the workforce. Eight years later, the government proposed the “NHS Dental Contract: Proposals for Pilots” to improve ac-cessibility to oral health and dental care. The pilot was based on three elements: registration, capitation, and quality. In 2015, the Department of Health announced the “Dental Contract Reform: Prototypes.” These prototypes include the clinical pathway, measurement and remuneration by quality of care, and a weighted capitation and quality model reimbursement system. Conclusions: The changes to the UK dental care system has implications. First, national coverage should be extended to improve accessibility to dental care. Second, the dental care system is necessary to reform focused on patient-centered and prevention. Third, registration and remuneration by quality of care needs to be introduced. Fourth, change should start from the basic steps, such as forming con-sensus or preparing manuals, to strengthening personnel and conducting a pilot study. Most of all, the new system will center on clinical leadership.

공중구강보건학 분야 : 강릉시노인의 일상생활구강영향지수 (OIDP) 분포양상

류재인 ( Jae In Ryu ),정세환 ( Se Hwan Jung ) 대한구강보건학회 2007 大韓口腔保健學會誌 Vol.31 No.2

광중합형 복합레진 충전 급여에 따른 소요재정 추계

류재인 ( Jae-in Ryu ),정세환 ( Se-hwan Jung ),한동헌 ( Dong-hun Han ),이새롬 ( Sae-rom Lee ),전지은 ( Ji-eun Jeon ) 대한예방치과·구강보건학회 2019 大韓口腔保健學會誌 Vol.43 No.3

Objectives: This study aimed to estimate the financial budget of light-curing composite resin fillings based on the expanded coverage of the National Health Insurance Service (NHIS), called “Moon Care.” Methods: The estimated population with dental caries and the amount of light-curing composite resins used were determined. The fees for the resin fillings per tooth were considered for the calculations. The expected budget for the next five years for children and adolescents aged 5-12 and 5-19 years were calculated. Results: During the first year of the coverage, the budget for children and adolescents aged <19 years was estimated to be 201.8 billion South Korean won (5-9 years, 17.9 billion South Korean won; 10-14 years, 76.6 billion South Korean won; and 15-19 years, 107.3 billion South Korean won). The total budget for the next five years for children and adolescents aged <19 years was estimated at 946.4 billion South Korean won. Likewise, the budget for children aged <12 years during the first year of the coverage was estimated at 63.9 billion South Korean won (5-9 years, 17.9 billion South Korean won and 10-12 years, 46 billion South Korean won), and the total budget for the next five years was estimated at 315.9 billion South Korean won. Conclusions: Government healthcare plans should be established based on treatment needs and financial estimations. All the items in the NHIS, including the light-curing composite resin filling, should be considered based on their contribution to oral health promotion. Furthermore, in the long term, the coverage for preventive health services should be included in the health insurance.

치과의사의 아동치과주치의 사업 평가에 대한 질적 연구

류재인 ( Jae-in Ryu ),박향아 ( Hyang-ah Park ),이선장 ( Sun-jang Lee ),전지은 ( Ji-eun Jeon ) 대한예방치과·구강보건학회 2021 大韓口腔保健學會誌 Vol.45 No.2

Objectives: This study aimed to evaluate the registered dentists’ program, from the dentist’s perspective, before its nationwide implementation. Methods: In-depth interviews were conducted with 18 dentists who had participated in the registered dentists’ program in G Province. A questionnaire was prepared based on previous research. The data were collected by transcription of interview recordings. Qualitative research methodology was implemented and the data were coded according to the grounded theory. A paradigm model was presented and the core categories were indicated. Results: The findings were organized into 6 categories, 25 subcategories, and 315 codes, based on open coding of the first categorization of collected data. The central phenomenon was found to be the experience of dissatisfaction with the program. The causal conditions were shown as problems of the program, while contextual and intervening conditions were shown as passive participation of dentists and positive effects of the program, respectively. The action/interaction strategies were summarized as an improvement plan and the consequence was an increased intention to participate. Conclusions: The study proposes the need to strengthen primary dental care through this registered dentists’ program, by performing continuous evaluations. The standards and guidelines, cooperation of participants, and appropriate compensation should be considered to promote successful implementation.

국내외 치과 의료수가 비교현황

류재인(Jae-In Ryu),김철신(Chul-Shin Kim),정세환(Se-Hwan Jung),신보미(Bo-Mi Shin4) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.4

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 지역사회 아동에서 구강건강 위험도 평가항목의 유용성 평가

류재인 ( Jae In Ryu ),김용진 ( Yong Jin Kim ),박주현 ( Joo Hyun Park ),김현주 ( Hyun Joo Kim ),김종애 ( Jong Ae Kim ),정종일 ( Jong Il Jung ),김철신 ( Chul Shin Kim ),정세환 ( Se Hwan Jung ) 대한예방치과·구강보건학회 2011 大韓口腔保健學會誌 Vol.35 No.2

Objectives. This study aimed to apply an oral health assessment model based on the care pathway to children and evaluate the validity of the risk assessment components in the model with regards to the oral health status of objective and subjective. Methods. 168 children from 8 community children centers in J district, S city, Gyeonggi-do participated in this study, while three dropped out. Finally, 165 children were selected as the study subjects (98.2% response rate). The oral health assessment form was adopted from the report of ``preliminary study of Primary Care Dentist System for Children (I)``. The independent variables were oral health risk assessment components and the dependent variables were df index, DMFT index, active dental caries in permanents teeth, gingival health status, and perceived oral health condition. Mann-Whitney test was used for the first two variables due to nonparametric distribution and chi-squared test was used for the last three. Results. There were significant mean differences for both dft index and DMFT index for the oral health risk assessments. DMFT index showed differences in 7 components of oral health risk assessment compared to the dft index, which did in 3 components. The existence of active dental caries in permanents teeth was statistically different in 5 oral health risk assessment components, the gingival unhealthy condition for 4 components, and perceived oral unhealthy condition for 1 component. Conclusions. ``High caries in mother and siblings`` in social history, ``new lesions since last check-up``, ``premature extractions due to caries``, ``heavily restored dentition`` in caries experience, ``evidence of gingivitis``, ``poor level of oral hygiene``, ``plaque retaining factors`` in periodontal disease experience/plaque showed statistically significant differences, whereas the other components did not.

초등학교 3~6학년 과학 교과서의 질문 방략 분석

류재인 ( Jae In Ryu ),한광래 ( Kwang Lae Han ),김효남 ( Hyo Nam Kim ),박국태 ( Kuk Tae Park ) 한국초등과학교육학회 2006 초등과학교육 Vol.25 No.2

일부 지역아동센터 아동에 대한 치과주치의 사업 3년간의구강건강상태, 진료 및 비용 분석

류재인 ( Jae In Ryu ),김용진 ( Yong Jin Kim ),박주현 ( Joo Hyun Park ),김현주 ( Hyun Joo Kim ),김종애 ( Jong Ae Kim ),정종일 ( Jong Il Jung ),홍민경 ( Min Kyeong Hong ),정세환 ( Se Hwan Jung ) 대한예방치과·구강보건학회 2014 大韓口腔保健學會誌 Vol.38 No.4

Objectives: This study aims to investigate the trends and progress in oral health status, dental serviceitems, and fees among children receiving community-based registered dental care over a three-yearperiod. Methods: The study subjects were selected from nine community children centers in J district of S city,in the Korean province of Gyeonggi-do. The sample included 222 children who had received care in2011 and 2012, and 205 children, in 2013. The dependent variables were oral health status (df indexand decayed-missing-filled teeth index), dental service items (total number of visits and dental fillingsby type), and dental fees (total fees, National Health Insurance [NHI] coverage, and NHI non-coverage),analyzed by year. The percentages of dental caries and dental service items were tested using chisquareanalysis, and the mean of each variable, including dental fees, was tested using the Kruskal-Wallis method, owing to non-parametric distribution. Results: There was a statistically significant decrease in the rate of dental clinic visits for treatment, andan increase in the mean numbers of filled teeth and sealants performed per year. The rate and numberof dental fillings increased steadily, whereas the services for oral health promotion and preventionwere decreased. The number of dental visits and the total fees decreased steeply, especially within thesecond half of the last measured year: around 90,000 earned within that time, compared to 170,000earned during the first year. Conclusions: Dental clinic visits should be encouraged on a regular basis for oral health promotion andprevention by both patients and providers using capitation payment systems, for example. It is necessaryto monitor and provide training for all related staff by developing a manual for oral health examinationand treatment, adjusted for the registered dental system. Policy measures addressing the needsof vulnerable social groups are needed more than ever. Therefore, it is important to provide as muchtargeted support and training to the registered dental system as possible.