Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지
DOI QR코드

DOI QR Code

The Demands and Awareness of Pediatric Dentists on the Korean National Health Insurance System

국민건강보험에 대한 소아치과 의사들의 요구와 인식 조사

  • Yunhyeong, Kim (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital) ;
  • Yongkwon, Chae (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital) ;
  • Koeun, Lee (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital) ;
  • Misun, Kim (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University) ;
  • Ok Hyung, Nam (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital) ;
  • Sungchul, Choi (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital) ;
  • Hyoseol, Lee (Department of Pediatric Dentistry, Kyung Hee University Dental Hospital)
  • 김윤형 (경희대학교 치과병원 소아치과) ;
  • 채용권 (경희대학교 치과병원 소아치과) ;
  • 이고은 (경희대학교 치과병원 소아치과) ;
  • 김미선 (경희대학교 치의학전문대학원 소아치과학교실) ;
  • 남옥형 (경희대학교 치과병원 소아치과) ;
  • 최성철 (경희대학교 치과병원 소아치과) ;
  • 이효설 (경희대학교 치과병원 소아치과)
  • Received : 2022.05.18
  • Accepted : 2022.06.23
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into 'general background of the respondents', 'the awareness on national health insurance (NHI) and DHI', 'the awareness on DHI pertaining to pediatric dentistry', 'issues that need improvement on DHI pertaining to pediatric dentistry', 'DHI claims', and 'the roles of KAPD in DHI'. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

이 연구의 목적은 치과건강보험에 대한 소아치과 의사의 인식과 견해를 조사하는 것이다. 대한소아치과학회 회원들을 대상으로 온라인 설문조사를 실시하였다. 총 문항 수는 41문항이며, 문항은 6개의 항목 '설문 응답자의 일반적인 특성', '국민건강 보험과 치과건강보험', '소아치과 영역의 치과건강보험', '소아치과와 관련된 치과건강보험 제도 개선점', '치과건강보험청구', '치과건강보험과 관련한 대한소아치과학회 역할'으로 이루어졌다. 총 302명이 응답하였고, 응답률은 28.9%였다. 기록이 미비한 2명을 제외하고, 총 300명을 분석대상으로 하였다. 소아치과 의사들은 치면열구전색술, 광중합형 복합레진 충전에 정량광형광기 치아우식검사에 비해 높은 만족도를 보였다(p < 0.017). 소아치과 의사들은 보험수가 인상이 가장 필요한 항목은 영구치 복합레진 충전(65.7%), 보험급여가 가장 필요한 항목은 불소도포(74.7%)라 생각하였다. 치과건강보험 청구는 대체로 치과위생사 또는 간호조무사가 담당하였다. 소아치과 의사들은 학회에서 치과건강보험에 대한 정보를 제공하는 것에 대해 긍정적으로 생각하였다. 이 연구는 향후, 소아치과 영역 치과건강보험제도의 정책적 발전을 위한 기초자료로 활용될 수 있을 것이라 사료된다.

Keywords

Acknowledgement

This study was supported by the fund from Korean Academy of Pediatric Dentistry (2021).

References

  1. Overview of national health insurance system. Available from URL: https://www.nhis.or.kr/nhis/policy/wbhada01000m01.do (Accessed on Mar 18, 2022). 
  2. Song YJ : The South Korean health care system. JMAJ, 52:206-209, 2009. 
  3. Chang YS, Ahn YW, Park JS, Ko MY : Dentists' opinions in the dental field of present health insurance clain and review. J Oral Med Pain, 30:215-230, 2005. 
  4. Hwang JM, Kim JH, Park YD : Dental service providers' satisfaction with dental health insurance. J Korean Acad Oral Health, 34:214-221, 2010. 
  5. Lee HS : A study on item variations in dental service reimbursement and payment status of national dental insurance treatment expense. Unpublished master's thesis Yonsei University, 2007. 
  6. Kim JS, Park JY, Han CH : Distribution of dental clinic's income from health insurance. Korean J Health Policy Admin, 12:84-102, 2002.  https://doi.org/10.4332/KJHPA.2002.12.1.084
  7. Han JH, Kim J : Client services evaluation in dentistry sector. J Korean Acad Dent Hyg Educ, 3:209-220, 2003. 
  8. Statistics of Relative value scale. Available from URL: http://opendata.hira.or.kr/op/opc/olapGanriJiro.do (Accessed on March 22, 2022). 
  9. Lee SH, Oh HW : Perceptions and behaviors of dental practitioners with regard to the National Health Insurance. J Korean Acad Oral Health, 38:246-253, 2014.  https://doi.org/10.11149/jkaoh.2014.38.4.246
  10. Kim JH, Park YD : Dental service provider's recognition of national health insurance coverage of denture. J Korean Acad Oral Health, 33:644-652, 2009. 
  11. Kim S : Changes in household health expenditure after health insurance coverage expansion and their policy implications. Health Welfare Policy Forum, 289:38-52, 2020. 
  12. Park YY, Lee SH, Jung JY, Kim SJ, Do GR, Oh HY, Kim JS, Lee JH, Han DH : The effects of National Health Insurance Policy on the dental health care service: focused on the dental implants, endodontic treatments, and tooth extraction. J Korean Acad Dent Insurance, 7:20-30, 2017. 
  13. Bae JS, Kim IH, Choi HJ, Song JS : Status and survey of pulp treatment by Korean pediatric dentists. J Korean Acad Pediatr Dent, 47:277-292, 2020.  https://doi.org/10.5933/JKAPD.2020.47.3.277
  14. Han JH, Kim YS : A study on awareness of the dental health insurance coverage. J Dent Hyg Sci, 8:65-71, 2008. 
  15. Petersen PE : The world oral health report 2003: Continuous improvement of oral health in the 21st century-the approach of the WHO Global Oral Health Program. Community Dent Oral Epidemiol, 31(Suppl 1):S3-S23, 2003. 
  16. Lee SH, Lee HS, Oh HW : Awareness of oral health workforce on the national health insurance coverage of topical fluoride application. J Dent Hyg sci, 15:46-53, 2015.  https://doi.org/10.17135/jdhs.2015.15.1.46
  17. Seo HW, Kim YS : Changes in dental cares utilization and expenditure by the expansion policy of the health insurance coverage : Korea health panel survey 2012-2016. J Korean Soc Dent Hyg, 20:611-621, 2020. 
  18. Kim J : A study on recognition and needs about national health insurance coverage of dental service. Unpublished master's thesis, Kyung Hee University, Seoul, 2010. 
  19. Shin YS : How to improve the national health insurance fee-for-service schedule. Health and Welfare Policy Forum, 6:39-52, 2019. 
  20. Shin HS, Ahn ES : Major dental service activity cost of National Health Insurance. Korean J Manag Account Res, 14:85-107, 2014. 
  21. Yu SA, Lee SY : Awareness & satisfaction of caregivers on the health insurance coverage of light-curable composite resin restoration. J Korean Soc Dent Hyg, 21:89-98, 2021. 
  22. Han JH : A study on priority-setting in expanding the dental health insurance coverage. Unpublished doctoral dissertation, Hanyang University, Seoul, 2007. 
  23. Kwon HK, Choi YH, Choi CH : The baseline study for insurance coverage of preventive treatment item on Korea National Health Insurance. J Korean Acad Oral Health, 26:271-281, 2002. 
  24. Yoo EM, Ahn SY, Choi HS, Hwang SH, Oh BK : A Study on the State of the Claim of Dental Medical Institutions for Payment from the National Health Insurance Corporation. J Dent Hyg Sci, 11:31-35, 2011. 
  25. Hong SA : A survey on health insurance claim affairs among dental clinics. J Korean Acad Dent Insurance, 1:17-27, 2010.