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.

치과 의료서비스의 질이 환자의 만족도와 재방문에 미치는 영향

김도희,박영지,이경은,이혜은,배성숙,강민경 한국치위생감염관리학회 2016 한국임상치위생학회지 Vol.4 No.1

Objectives: The purpose of this study was to investigate an effect of dental health service quality on patient satisfaction and intention to revisit. Methods: The subjects were 200 patients’ who visit dental clinic. Survey data were collected through mobile from May 27 to July 28 2015. Data were analyzed using the SPSS Statistics 21.0 Program. Results: There were not statically significant differences in patients’ satisfaction and intention to revisit according to gender(p>0.05). On the other hand, there were statically significant differences in patients’ satisfaction and intention of revisit according to age(p<0.05). The procedure of a reservation, hospital environment, service had statically significant positive (+) impacts on patients’ satisfaction and intention of a revisit The patient’s satisfaction showed significant correlation with intention of a revisit(p<0.05). Conclusions: The dental health service quality could affect patients’ satisfaction and intention of a revisit. Taken together, the establishment of dental management strategies can improve the quality of dental health service for the patients and provide high quality dental health service. However, further study will be needed to improve satisfaction for dental health service and intention of revisit.

치과공중보건의사의 교정시설 치과진료실태에 대한 인식 조사

황일광,박희경 대한치과의사협회 2022 대한치과의사협회지 Vol.60 No.2

Objective: To identify the status of dental services in Korean correctional institutions and suggest improvement measures. Methods: We surveyed 31 out of 32 dental public health doctors working at correctional institutions under the Ministry of Justice, to analyze the status of dental treatment provided in 47 such institutions. We also examined the dental public health doctors' awareness of dental services. Results: Thirty-seven percent of institutions had no radiation devices available for diagnosis, and 80.9% of institutions complained of a lack of radiation diagnostic equipment. In 78.7% of institutions, dental treatment by external doctors was performed regularly, and 93.5% of dental public health doctors thought that they were necessary. On the other hand, the need for a dental officer (including a dental public health doctor) was rated lower (74.2%). Among dental public health doctors, 83.9% said that the environment to deal with emergency situations was not sufficient, 64.5% were concerned about the disadvantages caused by medical accidents, and 61.3% thought that relief measures were insufficient. Futher, 66.0% of respondents said it was difficult to receive medical treatment at external hospitals if necessary. Moreover, 74.2% of dental public health doctors said working in correctional institutions was rewarding, and many doctors reasoned that it was not rewarding because they regretted not being able to provide high-quality treatment. As for the most urgent task to improve dental treatment for inmates, increasing dental assistants and changes in the consciousness of medical services and medical officers were suggested, among others, such as establishing a dental hospital for inmates, expanding equipment and materials for dental treatment, and recruiting external (invited) dentists. Conclusion: Dental public health doctors oversee dental services at Korean correctional institutions, and further research is urgently needed for its development. Improvements in dental services at correctional institutions should include increasing dental staff including assistants and external dentists, and expanding the equipment and materials for dental treatment.

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 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 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.

한국 청소년의 구강보건행태와 치과의료이용과의 연관성

최문실 ( Moon Sil Choi ),박형수 ( Hyun Su Park ),이병훈 ( Byung Hoon Lee ),정상길 ( Sang Gil Jeong ),박종 ( Jong Park ) 한국치위생학회 2010 한국치위생학회지 Vol.10 No.5

Objectives: This study examined the oral health behavior and dental services utilization of adolescents in order to provide information on how to disseminate the correct oral health behavior to the youth and develop programs for the approach. Methods: The raw data of `The Third 2007 Youth Health Behavior Online Survey` carried out by the Korea Center for Disease Control and Prevention were analyzed. All survey data collected was processed using SPSS ver 17.0 for data analysis as Frequency analysis, chi-square and Logistic regression analysis. Results: 1.The adolescents who have parents with college degree are 70% higher of dental services utilization than the adolescents counterpart(whose parents don`t have degrees). And also the adolescents living in cities are 1.3 times higher use of dental services than others living in countries. 2. In case of drinking soda, students having soda 4 days per week on average are 1.2 times higher use of dental services than who don`t. 3.The students brushing teeth after lunch are 0.9 times lower use of dental service than who don`t. And the students who have tooth ache whenever they have a meal are 1.6 times higher use of dental service than the students who don`t have tooth ache. The students who had a dental health education are 1.4 times higher utilization of dental service than who don`t. The difference of using dental service between the students who have gum disease and halitosis and the students who don`t is almost none. 4. The students who drink alcohol and smoke 10 days more or less a month are 0.8~0.9 times lower use of dental service than who don`t. Conclusions: The rate of utilizing dental service is higher at students who live with parents having college degrees and the more have oral health behavior, the less use of dental service for treatment. We concluded that more educational program should be developed and vitalized so that students can have oral health.

스케일링 건강보험 급여화 사업에 대한 인식 및 구강건강관리 관심도 변화

정은서 ( Eun-seo Jung ),김민지 ( Min-ji Kim ),박가영 ( Ga-young Park ),김민지 ( Min-ji Kim ),박주현 ( Ju-hyun Park ),김수경 ( Soo-kyung Kim ) 한국치위생학회 2018 한국치위생학회지 Vol.18 No.2

Objectives: To provide necessary information for stable establishment of the national dental scaling reimbursement system. Methods: This study was conducted in 380 adults in their twenties or older for about one month from July 2017. The questionnaires were composed of general characteristics, recognition (awareness) of dental scaling, knowledge of the dental scaling reimbursement program, changes in perception before versus after introduction of the dental scaling reimbursement program, and interest in oral health. To investigate into any factors affecting changes of interest in oral health care after introduction of the dental scaling reimbursement program, a multiple regression analysis was performed. Results: The investigation into any factors affecting changes of interest in oral health care after introduction of the dental scaling reimbursement program showed that higher usual interest in oral health (p<0.001) and the consideration that the dental scaling charges have been affordable after introduction of the scaling reimbursement program (p<0.01) led to more changes in interest in oral health care. Conclusions: The above-mentioned results suggest that the dental scaling reimbursement program has brought favorable changes in the perception of dental scaling. It is expected that the said program will contribute significantly to the improved national oral health, and the Government should make constant efforts to develop it as a long-term policy for oral health improvement.

한국 노동시장 불안정성과 미충족 치과의료의 관련성: 고용과 소득 불안정성을 중심으로

차선화 ( Xianhua Che ),박희정 ( Hee-jung Park ) 대한예방치과·구강보건학회 2018 大韓口腔保健學會誌 Vol.42 No.4

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the 9th wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

예방진료에 대한 일부 치과병원 의료진의 인식 및 요구도 파악을 위한 질적 연구

류재인,박현주,박향아 대한예방치과·구강보건학회 2022 大韓口腔保健學會誌 Vol.46 No.1

Objectives: This study aims to understand the perceptions regarding preventive dental services among dental professionals. Methods: In-depth interviews were conducted with three groups of dental professionals―dentists, dental hygienists, and dental hygienists that specialized in preventive service―who were selected using a convenience sampling method. Results: First, there was limited awareness among dentists regarding the need for preventive care, because of the treatment-oriented philosophy and scarcity of preventive care success models. Second, dental hygienists commented that there was a lack of the person in charge and systematic process for preventive services. It would not help when they decided to change working place even though they had high anxiety working for preventive care. However, both these professionals agreed that preventive treatment is important as the core of care and that it was important to develop various improvement methods to promote preventive services. Conclusions: To activate preventive services in dental clinics, it is essential to improve the operating system and encourage dental professionals to realize the importance of preventive services.