• Title/Summary/Keyword: 치과건강보험

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치면열구전색술(치아홈메우기) 건강보험 급여기준 개발

  • Lee, Sang-Ho;Lee, Gwang-Hui;Jang, Gi-Taek
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.654-666
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    • 2009
  • 우식활성이 높은 어린이와 청소년 전체를 수용할 수 있는 치면열구전색(치아홈메우기) 사업의 확대 재생산을 위한 방안으로 건강보험 급여에 포함하는 정책이 2009년 12월부터 실시됨에 따라 본 연구는 급여화 기준 설정, 상대가치지수 개발 및 수가산정, 소요 재정추계 등, 급여화 운용을 위한 제반사항을 연구, 개발하는데 그 목적이 있다. 본 연구에서는 치면열구전색술의 적응증, 실시연령, 대상치아등에 대해 문헌고찰과 함께 상기 항목에 대한 정책적인 면에서의 검토를 시행하였으며, 치과의사를 대상으로 전국규모의 설문조사를 실시하여 치면열구전색술의 상대가치지수(RBRVS)와 연계한 의사업무량을 산출하고, 행위 기술서를 작성하였으며, 직접 및 간접비용의 세부내역 산출하였다. 도출된 상대가치지수를 바탕으로 예상수가를 산정하였으며 이를 근거로 대상 연령 및 대상치아, 의료 이용율 대비 재정추계 시행하였다. 이와함께 치면열구전색술의 급여화 순조로운 정착을 위한 외국사례 연구, 보험적용추진을 위해 치면열구전색의 유지율 및 비용효과, 예방적 레진수복과의 차등화문제, 재료적 고찰, 대국민 및 시술기관 대상 홍보 사항 등 급여화에 관련된 제반 사항을 검토, 제안하였다.

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National Health Insurance Coverage for Dental Implant and Denture (진료현장의 건강보험 틀니와 임플란트의 건강보험진료)

  • Choi, Hyeonmi
    • The Journal of the Korean dental association
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    • v.54 no.6
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    • pp.457-467
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    • 2016
  • The National Health Insurance Service(NHIS) has been selectively covering the elderly on the dental implant and removable denture treatment and gradually expanding the eligibility criteria. Every dentist needs to have a good understanding of the insurance policy to provide qualified dental service to the beneficiaries and to avoid confusions and complications. In order to help dentists understand the NHIS requirements, the definitions, categories, and procedures of dental implant and conventional denture treatment are suggested.

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Dental Health Insurance Awareness and Satisfaction of Parents with Children 12 and Under (12세 이하 자녀를 둔 학부모의 치과건강보험 인식 및 만족도)

  • Lee, Yu-Hee;Lee, Jung-Hwa;Jang, Kyeung-Ae;Yun, Jung-Won
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.163-169
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    • 2020
  • The purpose of this study was to identify the degree of awareness and need for dental health insurance of parents with children under 12 years of age, and provide it as basic data for the development of the dental health insurance system in the future. It was conducted with 158 parents who are raising children under the age of 12 in Busan and Gyeongnam areas. In the case of mothers(p=.001), the higher the age (p=.005), the higher the experience of sealant. In the case of mothers, the knowledge of sealant (p=.012) was high. When the gender was female (p=.026), the parenting relationship was mother (p=.006), and regularly engaged in vocational activities (p=.003), the awareness of resin filling was high, and the experience was the child's age (p=. 004) was higher, the higher the knowledge was when the parenting relationship was mother (p=.024). The factors influencing the satisfaction of sealant were found to be the parents education level (p=.004), the awareness of the sealant (p=.003), and the experience (p=.011). From the above research results, more active publicity is needed to increase the awareness and experience of parents' health insurance.

A Study on the State of the Claim of Dental Medical Institutions for Payment from the National Health Insurance Corporation (치과 의료기관의 건강보험 청구실태)

  • Yoo, Eun-Mi;Ahn, Se-Youn;Choi, Hye-Sook;Hwang, Sun-Hee;Oh, Bo-Kyung
    • Journal of dental hygiene science
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    • v.11 no.1
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    • pp.31-35
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    • 2011
  • The purpose of this study was to examine the state of the claim of dental clinics for payment from the national health insurance corporation in a bid to provide some information on the efficient management of payment claim by dental institutions. The findings of the study were as follows: As for the form of payment claim, 45.4 percent claimed payment by themselves, and 54.6 percent asked an agent to do that on behalf of them. Concerning the type of occupation of the applicants, dental hygienists demanded payment in the biggest number of the dental clinics(78.2%). The most common number of cases that the dental clinics demanded payment was between 201 and 400(40.3%). The dental clinics asked an agent to claim payment when the number of payment claim cases was smaller, and they claimed payment by themselves when the number of payment claim cases was larger. Regarding the reason why the dental institutions asked an agent for payment claim, the biggest group(28.0%) cited complicated claim procedure as the reason, and the second largest group(22.6%) answered that they weren't used to doing that. The third greatest group(20.8%) pointed out a shortage of personnels that would be responsible for that as the reason.

치과병원 증가, 양질 진료 서비스냐, 과다 진료비 청구냐

  • The Korean Dental Association
    • The Journal of the Korean dental association
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    • v.38 no.10 s.377
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    • pp.935-941
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    • 2000
  • 건강보험심사평가원이 파악한 전국의 치과병원 개수는 48개(대학의 치과병원, 국공립 치과병원 제외) 이중 올해 새로 개설신고한 치과병원이 16개에 이른다. 치과병원의 증가로 치과의사의 활로 개척 및 수련기회의 증가, 연계된 진료 및 질 높은 진료 가능 등 긍정적 측면도 있으나 과다한 시설투자로 인한 지나친 요금 청구, 주변 개원의와의 마찰, 과대광고의 가능성 등 문제점도 제기되고 있다. 이에 치과병원의 현황을 살펴보고 치과병원의 긍정적인 측면과 부정적인 측면 등을 살펴보도록 한다.

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