국민건강보험 치석제거 서비스 급여 적용 대상자 확대 정책의 효과 평가

김우종,신영전 대한예방치과·구강보건학회 2022 大韓口腔保健學會誌 Vol.46 No.4

Objectives: Korea’s National Health Insurance (NHI) coverage rate for dental services is 16.0%, far lower than the 33.0% average of OECD (Organization for Economic Co-operation and development) countries. In 2013, the government implemented a policy to pay for dental scaling service for adults over the age of 20. Then in 2017, the eligibility criteria was expanded to adults aged 19 or older the eligibility age was lowered expanded to 19 or older. Methods: The study aimed to determine the effectiveness of the policy by comparing the number of times per person the dental scaling service was used before and after the implementation of the new applicants group compared to the existing application/applicants group. The analysis was conducted among patients aged 19 and 20 who visited the hospital with gingivitis and periodontal disease and who used the dental scaling service more than once per year as a preventive measure, using the customized database of the NHIC (National Health Insurance Corporation). As of July 1, 2017 when the dental scaling service was implemented by the National Health Insurance Service, the period was set as “before enforcement” (January 2016 to June 2017) and “after enforcement” (July 2017 to December 2018). To evaluate the policy effectiveness of expandingthe ages of individuals eligible for the dental scaling service, Difference-in-Differences (DiD) analysis was conducted to examine the number of times per person the service was used, changes in personal contributions, and policy effectiveness. Results: Since the National Health Insurance policy to pay for dental scaling services, both the applicants group and the sustainable application group have increased the rate of inspection of preventive dental scaling services (19.82%→30.91%, 29.68%→31.18%). As a result of determining the pure effect of the NHI’s policy of covering the dental scaling service, it was found that the the number of times the dental scaling service was used per person increased significantly in the new application group (0.03 times, <.0001). Conclusions: However, it was found that the cost of the dental scaling service per person while the cost of the dental scaling decreased was shown to decrease, it was not statistical significant. Therefore, additional policy support such as lowering the personal financial burden is needed for those who are unable to afford the service.

일부 치과병원의 예방진료에 대한 내원 환자의 인식 및 요구도 파악을 위한 탐색적 연구

박현주 ( Hyunju Park ),류재인 ( Jaein Ryu ),박향아 ( Hyangah Park ) 대한예방치과·구강보건학회 2021 大韓口腔保健學會誌 Vol.45 No.1

Objectives: This study aims to identify the factors related to the consultation and use of preventive dental services among patients visiting dental clinics. Methods: The self-reporting questionnaire survey was conducted among patients in Busan, South Korea, and overall, 319 patients participated in this study, with a response rate of 83.9%. Results: Among the study participants, 74.6% stated that preventive service was necessary and 193 patients (60.5%) agreed to undergo consultation for preventive dental service. Consequently, 66.3% of patients who underwent consultation agreed to participate in preventive dental service. The most popular reason provided to receive this service was “to maintain teeth longer” (72.9%), whereas the common factor for declining was “lack of time” (49.3%). Most people who did not attend the consultation of preventive dental service mentioned that the dental staff “did not recommend the consultation” (43.9%). Logistic regression analysis for the consultation and service use for preventive dental service showed that dental clinics, age, and satisfaction were the most influential factors. Conclusions: Both the characteristics of patients and dental clinics were important factors for people to agree to the consultation and use of preventive dental services. If dental staff launch efforts to improve the quality of service for the satisfaction of patients, it will increase participation in preventive dental services, which could help promote oral health and patients’ quality of life.

노인 환자의 만족도가 치과의료기관 재이용에 미치는 영향

우승희,김은주,이재라 대한치과위생학회 2017 대한치과위생학회지 Vol.19 No.2

The purpose of this study was to closely examine how the satisfaction plays a role as a mediating variable of reuse and positive promotion through analyzing the satisfaction with dental institutions of being used by the rapidly-growing elderly population and through investigating the influence of users' satisfaction upon intention of reuse. The following conclusions were elicited. First, the satisfaction at dental institutions in Mokpo area as the subject of this study appeared to be relatively high level. Especially, the satisfaction with dentists and dental hygienists stood at 4.30 points and 4.39 points, respectively, thereby having shown a very high outcome. And as a result of having surveyed the intention of public relations, the intention of recommending to people around, and the intention of a preferential choice in terms of the reuse, a slightly high level was indicated with 4.26 points, 4.29 points, and 4.20 points. Second, in consequence of having surveyed a difference in dental service satisfaction depending on general characteristics, the satisfaction at the facilities & environment, and at dental hygienists showed a difference according to gender. Men were surveyed to have a higher satisfaction than women. A statistical significance was indicated. Compared to National Health Insurance participants, the Medical Aid Beneficiaries were surveyed to have a higher satisfaction with the facilities & environment, with reception & administration, and with dental hygienists. Third, as a result of having surveyed a correlation between the dental institution satisfaction and the reuse-related question, a positive correlation was shown in all of the satisfaction with the intention of public relations, with the intention of recommending to people around, and with the intention of preferential choice. Thus, it could be known that the higher satisfaction leads to getting higher even in possibility of reuse. In this way, the satisfaction at dental institutions has positive influence upon selecting and re-using dental clinics. Hence, the dental institutions need to constantly strive to improve quality of medical service. To do this, a positive effort and investment should be made. A systematic program is considered to be likely necessary for reinforcing service quality and intensifying competitive edge. And to promote the dental institution's service quality based on the results of this study, it is considered to be likely needed introduction and activation of the dental institution accreditation system. Many dental institutions were changed now in comparison with the past. But the dental institution accreditation system is being autonomously enforced, thereby causing polarization in an institution with the execution of dental institution accreditation system and in an institution with its opposite case. Accordingly, an institutional device is needed that can supplement this. There is a need to establish the specialized and organized quality control system in order to step up quality of medical service.

예방치과서비스 경험 유무와 치과 공포도에 관한 연구

김수경 ( Soo-kyung Kim ),박하란 ( Ha-ran Park ),이다은 ( Da-eun Lee ),이수정 ( Su-jeong Lee ),정은서 ( Eun-seo Jung ) 한국치위생학회(구 한국치위생교육학회) 2018 한국치위생학회지 Vol.18 No.3

Objectives: This study was conducted to examine the degree of dental fear according to the experiences of the preventive dental care services. Methods: A self-administered survey was conducted in the subjects of male and female teenagers who lived in Seoul and Gyeonggi-do areas, and 231 copies of collected data for a month from July 26, 2017 were analyzed to find the following results. Results: In terms of the experiences of the preventive dental care services, they were classified in the order of preventive scaling (67.5%), education of toothbrushing (60.6%), fluoride application (49.8%) and sealant (44.2%). For the degree of dental fear according to their general characteristics, treatment avoidance factor (2.56±1.19) in the married was higher than that in the unmarried. All of treatment avoidance, physiological response and fearful stimulus induction factor, and the entire degree of fear were higher when there were experiences of the preventive dental care services than those without such experiences. The factors affecting the degree of dental fear included dental health conditions, experiences of toothbrushing education, sealant and fluoride application. In case those without the experiences considered their dental health condition was not healthy, the degree of dental fear was increased. Conclusions: This study verified that the degree of dental fear was increased in case no experiences of the preventive dental care services. Therefore, it is necessary to seek out the measures for promotion of the preventive dental care services, to reduce the degree of dental fear and enhance the dental health.

치과의료 서비스품질요인과 환자만족도와 추천지수 (NPS)와의 연관성

강종오 대한통합치과학회 2020 대한통합치과학회지 Vol.9 No.1

The purpose of this study is as for the relationship between variables affecting dental patients’ satisfaction and NPS (Net Promoter Score), to improve the quality of dental care service and positive marketing of the dental clinic. A total of 287 patients were selected through random sampling from dental clinics in Seoul, Gyeonggi-do city. The data were analyzed by SPSS Statistics 22.0, t-test and one way ANOVA, Pearson correlation and multiple regression analysis. The dental facilities factors, human service factors, dental treatment process factors are related patients’ satisfaction (p<0.001). Service quality value was significantly positively correlated with NPS (r=0.687, p<0.001). The staff’s kindness was the largest factor affecting the patients’ satisfaction (β=.380, p<0.001). The satisfactory service factors was accounted for 70.2% of NPS. Conclusionally, factors affected NPS were staff’s kindness, specialization of the dentist, physical environment, response of dental hygienist to patient, convenience dental care process. Therefore, it is necessary to promote dental facilities, professionalism of dentist and dental hygienist, staff’s kindness, dental treatment process for qualitative dental care service.

치과 내원환자들의 스켈링과 정기검진 및 전화서비스와의 관련성

김윤정 ( Yun Jeong Kim ),김선영 ( Seon Young Kim ),김지희 ( Jee Hee Kim ) 한국치위생학회(구 한국치위생교육학회) 2014 한국치위생학회지 Vol.14 No.1

Objectives: The purpose of the study is to investigate satisfaction, awareness and utilization of dental telephone services in dental clinic patients. Methods: A self-reported questionnaire was filled out by 220 dental clinic patients in G metropolitan city from March 11 to September 27, 2013. The data were analyzed by a descriptive analyses χ2 -test and relevant factors were determined using logistic regression analysis by SPSS 12.0. Results: The experience rate of scaling was 68.0% and the average number was 1.04±1.13. The experience rate of regular check-up was 41.0% and the average number was 1.01±1.29. Satisfaction and utilization rate of scaling and regular checkup was higher than that in those who did not receive the services. The major variables influencing the experience of scaling were woman, utilization of dental telephone service and regular check-up were awareness, utilization of dental telephone service and reason of utilization of dental telephone service(preventive). Conclusions: The dental telephone service in dental patients improved oral health. Accordingly, it is necessary to develop the professional dental hygiene program for oral health in dental patients.

치과의료 미충족에 영향을 미치는 요인에 대한 다수준 분석: 연령대별 비교를 중심으로

김우종 ( Woo Jong Kim ),신영전 ( Yong Jeon Shin ) 대한예방치과·구강보건학회 2021 大韓口腔保健學會誌 Vol.45 No.3

Objectives: The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. Methods: Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. Results: The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. Conclusions: In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.

SERVQUAL모형으로 측정한 치과 의료기관 서비스의 질

손소현 ( So Hyun Son ),권영대 ( Young Dae Kwon ),최인영 ( In Young Choi ) 대한예방치과·구강보건학회 2009 大韓口腔保健學會誌 Vol.33 No.3

Objectives: The quality of service becomes a crucial factor in the dental health care field. This study examined the expectations and perceptions of patients regarding the dental service quality, as well as the difference between expectations and perceptions. Methods: The survey measuring the expectations and perceptions of dental service was carried out on 480 patients from 16 dental institutes in the Seoul metropolitan area. SERVQUAL measurement included five dimensions: `tangible`, `reliability`, `responsiveness`, `assurance`, and `empathy`. Results: Validity and reliability tests were conducted to combine the reliability and responsiveness. The modified SERVQAUL model including four dimensions was analyzed using a t-test and ANOVA to examine the quality gap between expectations and perceptions. The tangible aspect was perceived to have higher perception than their expectations of the dental service provided, and the reliability and responsiveness dimensions had higher expectations than perceptions. In addition, the gap between perception and expectation was significantly different in some demographic and institute groups. Conclusion: These results showed that dental service is perceived with higher service quality in the tangible characteristics compared to other dimensions. The intangible characteristics also play an important role in gaining positive perception in the dental services. Therefore, in addition to the tangible characteristics, the intangible dimension, particularly reliability and responsiveness, should be improved.

치과 서비스특성과 신뢰 및 고객충성도 관계에서 감정적 몰입과 계산적 몰입의 인과적 역할

최철재(Chul-Jae Choi) 한국콘텐츠학회 2016 한국콘텐츠학회논문지 Vol.16 No.1

본 연구의 목적은 치과서비스를 대상으로 서비스 개별성, 서비스 능력, 서비스 공감성 등 서비스특성이 신뢰, 감정적 몰입 및 계산적 몰입에 미치는 영향력을 확인하고, 또한 신뢰, 감정적 몰입, 계산적 몰입, 고객충성도 관계를 확인함으로써 감정적 몰입과 계산적 몰입의 인과적 역할을 설명하는데 있다. 본 연구는 SPSS 20.0 및 AMOS 16.00 통계패키지를 이용하여 구조방정식모형분석으로 연구가설을 검증하였다. 분석결과 첫째, 서비스개별성은 감정적 몰입에 영향을 주었고, 서비스능력은 신뢰에 영향을 주었으며, 서비스공감성은 감정적 몰입 및 신뢰에 영향을 주었지만, 계산적 몰입은 어떠한 서비스특성에 영향을 받지 않았다. 둘째, 신뢰는 감정적 몰입에는 영향을 주지 않은 반면 계산적 몰입 및 고객 충성도에는 긍정적인 영향을 주었다. 셋째, 감정적 몰입 및 계산적 몰입은 고객 충성도에 긍정적인 영향을 주었다. 따라서 치과서비스제공자는 이용자에게 서비스 능력과 공감성을 제시하여 신뢰를 높이고, 서비스 개별성과 공간성으로 감정적 몰입을 높이는 차별적 관계형성이 필요할 것이다. 또한 신뢰가 형성된 고객은 직접적으로 고객충성도를 유도하거나 또는 다양한 혜택을 제시하여 간접적으로 고객충성도를 구축해야 하며, 감정적 애착이 높은 고객은 강력한 고객충성도를 구축할 수 있도록 적합한 마케팅전략을 제시해야할 것이다. The purpose of this study is to identifies services characteristics such as service customization, service ability, service empathy impacts on trust, affective commitment and calculative commitment, and explains causal role of affective commitment and calculative commitment by verifies relationships between trust and affective commitment and calculative commitment and customer loyalty in dental service setting. Analysis of structural equation modeling with SPSS 20.0 and AMOS 16.0 were performed to test the research hypothesis. The result of the study as follows: First, it was found that service customization had effect on affective commitment, and service ability had influence on trust, and service empathy impacts on both trust and affective commitment, but calculative commitment was not found to significant path coefficients in relationships with service characteristics. Second, trust had effects on calculative commitment, but not affective commitment. Third, affective commitment and calculative commitment positively had influence on customer loyalty. Therefore, Dental service providers should be increase user confidence by showing empathy and the ability to service. Customer who had formed trust is to build customer loyalty by inducing loyalty directly or by presents a variety of benefits indirectly. The high emotional attachment customer will have to present a suitable marketing strategies to build strong customer loyalty.

서비스 전문성이 고객만족, 신뢰, 그리고 재구매 의도에 미치는 영향

정옥경 ( Ok Kyung Jung ),김인규 ( In Kiw Kim ),박철 ( Cheol Park ) 한국고객만족경영학회 2011 고객만족경영연구 Vol.13 No.1

최근 우리 사회는 경제 발전과 더불어 국민들의 소득증가와 평균수명의 연장으로 인한 의료서비스에 대한 수요가 점점 늘어나고 있다. 의료기관은 양적으로 증가하고 있고, 의료시장 개방과 같은 외부환경의 급격한 변화로 인하여 의료시장의 경쟁은 날로 심각해지고 있으며 의료기관의 경영난은 더욱 더 악화되고 있다. 이제 의료서비스 기관들도 수요자인 환자, 고객 중심으로 변화되어야 한다. 이러한 상황 속에서 최근의 의료서비스 연구에서는 핵심 의료서비스 뿐만 아니라 부가 의료서비스에 대한 관심도 높아지고 있다. 하지만 의료서비스에서 부가 서비스에 대한 연구는 그 중요성이 부각됨에도 불구하고 아직 많은 연구가 이루어지지 않고 있다. 따라서 본 연구에서는 의료서비스를 대상으로 기존의 문헌을 바탕으로 서비스 전문성을 핵심의료서비스와 부가의료서비스로 정의를 하고 서비스 전문성이 고객만족, 신뢰, 그리고 재구매 의도에 어떤 영향을 미치는가를 의료서비스 고객 246명을 대상으로 실증 조사하였다. 그 결과 의료서비스에서 서비스 전문성(핵심서비스전문성, 부가서비스전문성)이 고객만족과 신뢰에 긍정적인 영향을 미쳤으며, 이 만족과 신뢰는 재구매에도 긍정적으로 영향을 미치는 것으로 나타났다. 이를 바탕으로 의료서비스마케팅 전략을 수립하기 위한 시사점을 토의 하고, 연구의 한계점과 향후 연구방안을 제시하였다. The demand on the medical service in our society keeps increasing together with the economic advance, increase in people`s income and the longer life expectancy of people. The number of medical treatment institution also keeps increasing. Accordingly, the competition in the medical market is also getting more severe and the management difficulty of medical institutions are becoming more serious, caused by external environment; such as the increase in the number of medical institutions and the opening of medical service market to foreign medical service providers. Within that competition and change, the market initiative also moved from the medical service suppliers to medical service consumers. The medical service market is now rapidly changing to patient-focused, client-focused market. Accordingly, in the medical service researches, there is more interest on the auxiliary medical service, in addition to the core medical service. However, compared to the interest, there are not many researches on the auxiliary medical service till now. This research defines the expertise of medical service as Core Medical Service and Auxiliary Medical Service, based on the existing research literature. The research has its purpose is providing with practical suggestions regarding the impact of service expertise on the relative activities with the customers and what impacts such activities will have on the re-purchase intention of the customers, using empirical research method. As the result of the research, it has been found that the service expertise (core service expertise and auxiliary service expertise) have positive impact on the customer satisfaction and reliance. And such satisfaction and reliance again had positive impact on the re-purchase intention of medical service by the same customer. Based on these findings, the issues in the establishment of medical service marketing strategy were discussed and presented, together with the limitations of research and suggestions on the future research direction.