• 대한치과의사협회지
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• 제51권5호
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• pp.265-273
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• 2013

The insurance payment plan for dental implants in Korea has been criticized because the payment priority has not been properly established, and the benefits are concentrated among middle-class citizens. In the current study, the relationship between the oral health condition and socioeconomic status of the elderly was analyzed using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study aims to determine the reason underlying the criticism of the insurance payment plan. The subjects were >65-year-old individuals in the 2010 and 2011 database of KNHANES. Data from 2,812 subjects were analyzed. The socioeconomic status was determined based on edentulousness, molar tooth loss, and presence of 28 teeth. According to the analysis, the average income was 1,560,000 won for edentulous elderly, 1,811,000 won for elderly who had lost molar teeth, and 1,896,000 won for elderly with 28 teeth (p<0.05). In addition, elderly with a low education level demonstrated a poor oral health condition (p<0.001). In conclusion, the insurance plan currently under examination is not properly designed for economically impoverished elderly because the plan only covers 50% of the costs and is limited to implantation of molar teeth only. This plan will not provide practical benefits to elderly with a poor socioeconomic status; therefore, the insurance payment plan needs to be improved so that the appropriate beneficiaries can be targeted.

• 치위생과학회지
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• 제11권5호
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• pp.381-388
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• 2011

본 연구는 중국인 유학생을 대상으로 치과의료 이용 실태에 대해 조사함으로써 외국 유학생의 치과의료 이용에 대한 문제점을 개선하고 치과의료서비스 확충을 위한 기초자료를 제공하고자, 2011년 4월 1일부터 7월 15일까지 국내 8개 대학에 재학 중인 중국인 유학생을 대상으로 조사를 실시하여 다음과 같은 결과를 얻었다. 1. 국내 치과의료기관 이용 경험에 관한 질문에서 응답자의 14.4%가 국내에서 치과치료를 받은 경험이 있었으며, 이용한 치과의료기관 분류로는 치과의원이 52.5%로 가장 많았고, 치료받은 내용으로는 충치(충전)치료가 52.8%로 가장 많은 것으로 나타났다. 2. 국내 체류 중 치과치료를 받지 못한 경험에 대한 이유는 '비용이 부담스러워서'가 38.7%로 가장 많았으며, '시간이 없어서'라는 응답도 29.8%로 조사되었다. 3. 건강보험에 가입되어 있는 경우가 57.3%로 가입되어 있지 않은 경우보다 약간 많았으며, 건강보험의 필요성을 묻는 질문에서는 대부분 필요하다고 응답하였다. 또한, 건강보험에 가입한 경우 가입하지 않은 경우 보다 치과치료를 더 많이 받은 것으로 조사되었다(p<.001). 4. 치과의료 이용 만족도에서는 한국어 실력이 좋을수록 치료 만족도가 높은 것으로 조사되었으며(p<.01), 건강보험에 가입되어 있는 경우 가입하지 않은 경우보다 치료 만족도가 높았다(p<.05). 이러한 결과는 중국인 유학생의 효율적인 치과의료 이용을 위해서 유학생의 건강보험 가입에 관한 제도를 개선하고, 보건의료 관련 행정 지원이 필요할 것으로 사료된다.

• 치위생과학회지
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• 제15권6호
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• pp.703-711
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• 2015

본 연구는 편의 추출된 30대~50대 성인 남녀 266명을 대상으로 치과치료비 본인부담금 스트레스, 비급여 치과치료 건강보험 확대, 민영 치과단독의료보험 가입 의사를 설문조사하였다. 건강보험 비급여 본인부담금 스트레스가 급여 본인부담금 스트레스에 비해 높으며, 교정, 임플란트, 틀니, 보철, 비급여재료 치아우식증 치료 순으로 스트레스 수준이 높았다. 치과치료에 있어서 건강보험확대는 필요하며 필요 순으로는 비급여재료 치아우식증 치료, 보철, 교정 순이었다. 연령제한이 있는 급여항목에 대해서는 적절하다는 응답이 치석제거 57.1%, 틀니 23.3%, 임플란트 14.3%였다. 구강상태가 나쁘다고 응답한 대상자는 급여 본인부담금과 비급여 본인부담금 모두에서 스트레스 정도가 유의하게 높으며 보철, 치아교정에 대한 건강보험 확대요구가 유의하게 높았다. 민영의료보험 가입자 중 치과치료를 보장하는 대상자는 18.3%, 민영 치과단독의료보험에 가입한 가입자는 8.3%였으나, 민영 치과단독의료보험 가입의사는 68.4%였다. 일반적 특성에 따른 민영 치과단독의료보험 가입의사 차이는 나타나지 않았고, 치과치료비의 부담정도와 민영 치과단독의료보험 가입필요 정도의 상관분석 결과, 임플란트 0.408, 비급여 치아우식증 치료는 0.404, 틀니 0.394, 보철치료 0.375, 치아교정 0.313 순으로 나타났다. 따라서, 적기치료가 가능하도록 급여 치과치료 본인부담금에 대한 부담 감소를 위해 치과치료 건강보험 급여 확대, 민영 치과단독의료보험 개발과 이에 따른 정부의 감독이 필요할 것으로 생각되었다.

• 한국치위생학회지
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• 제19권3호
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• pp.409-419
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• 2019

Objectives: The purpose of this study was to analyze the factors affecting antibiotic prescription in dental outpatients. Methods: The present study was conducted using data from the National Health Insurance Service - National Sample Cohort. We analyzed prescriptions issued in the dental outpatient department in 2015, for adults over 19 years of age. Antibiotic prescription rates and mean prescription days were analyzed by sex, age, insurance type, presence of diabetes mellitus and hypertension, season in treatment, type of dental institution, and location of dental institution. Multivariate logistic regression was also performed to analyze the factors affecting antibiotic prescription in dental outpatients. Results: A total of 257,038 prescriptions were analyzed. The mean prescription days of antibiotics in dental outpatients were $3.04{\pm}1.08days$, and the prescription rate was 93.0%. Two variables (presence of diabetes mellitus and insurance type) were excluded from the multivariate logistic regression analysis model because they did not significantly affect antibiotic prescription. The possibility of antibiotic prescription was higher in men ${\geq}61years$ of age and those with hypertension. Furthermore, antibiotics were most frequently prescribed in dental clinics rather than dental hospitals, and more frequently in Busan compared to other areas (p<0.001). Conclusions: Several factors were determined to affect antibiotic prescription, and detailed guidelines for consistent antibiotic prescription are needed.

• 대한장애인치과학회지
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• 제14권1호
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• 치위생과학회지
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• 제18권3호
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• pp.182-187
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• 2018

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• 대한치과기공학회지
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• 제40권2호
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• pp.73-82
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• 2018

Purpose: The purpose of this study was to investigate the production environment of crown prosthesis for National Health Insurance(NHI) benefit. Methods: This study carried out self-administered questionnaire survey from September 1, 2016 to October 31 by having research subjects as 261 dental technician. Except 100 copies with incomplete response, 161 copies were used as the materials of final analysis. Results: Unlike gold crowns, the material cost of metal crowns was paid at the dental laboratory(86.3%). Total material consumption for making metal crown was more than gold crown(63.4%), especially for the finishing and polishing processes(78.3%). The subjects responded that a routine dental laboratory fee of crown prosthesis is unreasonable, and it is necessary to adjust and improve it(metal crown 96.2%, gold crown 96.9%). NHI coverage dental prosthesis was not marked on the order form(46.0%), and the dental laboratory fee of that was nor received(64.0%). Conclusion : It is necessary to estimate the NHI cost level of the crown prosthesis by reflecting the production environment and engineering process in dental laboratories. In addition, institutional arrangement should be backed up so that dental laboratories can receive appropriate dental laboratory fee.

• 대한치과의사협회지
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• 제54권8호
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• pp.604-612
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• 2016

The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

• 한국치위생학회지
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• 제15권1호
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• pp.31-38
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• 2015

Objectives: The purpose of this study is to investigate the factors of oral health beliefs on scaling performance by national health insurance coverage in consumers. Methods: The subjects were 353 people living in Seoul, Incheon, and Gyeonggi-do from September 25 to October 20, 2013. They filled out the self-reported questionnaire after receiving informed consents. The questionnaire included 6 questions of general characteristics, 6 questions of oral health behavior, 6 questions of health insurance coverage, and 1 question of subjective oral health recognition. The oral health belief consisted of 6 questions of seriousness, 6 questions of susceptibility, 8 questions of barriers, 5 questions of benefit, and 3 questions of self-efficacy measure by Likert 5 scale. Cronbach's alpha in the study was 0.759. Data were analyzed using SPSS version 20.0 for frequency analysis, t-test, ANOVA, post-hoc Scheffe test, Pearson's correlation coefficient, and binary logistic regression. Results: The influencing factors of oral health belief model were Seriousness(${\beta}=0.091$), Self efficacy(${\beta}=-0.471$) and age(${\beta}=0.855$)(p<0.05). Those who had highly perceived seriousness and younger age tended to have probability of scaling performance. Higher self-efficacy tended to take more chance to have scaling performance probability. Conclusions: In order to cover the scaling by national health insurance, it is very important to notice the benefit of health insurance coverage of scaling to the consumers. National health insurance coverage enables the scaling practice to be easily accessible to the people. Easy access to scaling by low cost strategy can improve the oral health behavior.