Seo, Hyewon;Lee, Bo-Ah;Lim, Hyunsun;Yoon, Joon-Ho;Kim, Young-Taek
Journal of Periodontal and Implant Science
/
v.49
no.4
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pp.248-257
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2019
Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.
Migration studies that assume that decision making is done on an individual basis is overlooking the importance of the family factor. Considering that must people belong to families, it is more appropriate to view migration decision from the perspective of the family. This study analyzes the household migration decision whereby the alternatives are to stay, 10 undertake family migration or to undertake single migration of a member. In developing a conceptual model of household migration decision, it is assumed that the household's objective is to maximize household income which is a function of individual members' earnings. The benefits and costs of household migration and individual migration are identified and the household chooses the migration strategy that maximizes expected household income. When household members have conflicting earning prospects in the potential destination, the household considers single migration of the member with the best earning potentials. However, lone migration by a household member involves cost of family separation which is both monetary and psychic, and this study shows that lone migration is undertaken only when its net gains to the family are greater than the separation cost of the family. The major benefit of choosing single migration is the retention of home base in the place of origin which can serve as an insurance against the uncertainty of obtaining a job in the destination, the benefit that is unavailable in family migration. The conceptual analysis shows how a household's migration decision would depend on its members' economic roles and prospects in the destination. Besides the economic variables, social and life cycle variables of the family translate into separation costs and benefits of migration. This study indicates that one - earner family in low economic status but with good earning prospects and high separation costs is more likely to choose family migration over single migration.
The purpose of this study was to investigate the current status of unmet medical need using data from the Korea Health Panel study from 2009 to 2013 (excluding 2010), and to analyze the trends of unmet medical need and related factors. The subjects of this study were 11,598 in 2009, 11,035 in 2011, 10,584 in 2012, 10,099 in 2013, and 7,144 people in panel data, and conducted frequency analysis, chi-square test and generalized estimating equation. As a result of the analysis by year, it was found that women, under middle school graduation, medical aid, the lowest household income and low subjective health status experienced more unmet medical need. As a result of analysis using generalized estimating equation, women, under 40 years of age, under elementary school graduation, lowest quartile household income, subjective health status of less than 20 points, and activity restrictions are more likely to experience unmet medical need. Based on these results, we intend to provide basic data for establishing policies on the use of medical services.
Given the limitations of UI benefit and self-insurance through precautionary savings, this paper suggests a new scheme of income support for the unemployed, which offers unemployed workers not only UI benefit but also borrowings from their future pension incomes. Allowing individuals to have effective self-insurance through pension- borrowing, this scheme provides them with consumption-smoothing and reduction in risk burden while maintaining search incentives of the unemployed. Simulation study based upon household panel data in Korea suggests that a heavy reliance should be set upon self-insurance through pension-borrowings rather than upon UI benefit, even for the low-income individuals who are subsidized under UI system. This result provides us with insightful implications for a social safety net in (fast-growing) developing countries, where people cannot afford a good amount of UI benefit or of precautionary savings against unemployment although they expect their incomes to be much higher in the future. Indeed, it is consumption-smoothing effect of self-insurance through pension- borrowings, as well as its incentive-maintaining effect, that makes it a promising alternative of social safety net in developing countries.
Objectives: The aim of this analysis was to investigate factors associated with dental visits in terms of getting diagnosis and receiving care for diagnosed dental diseases among Korean adults. Methods: Data used in this analysis were from the 2005 Korean National Health and Nutrition Examination Survey which involved a representative sample of 25,487 adults nineteen years of age and older who resided in Korea. This analysis used data of adults who had completed health interview survey (n = 25,215). Uni- and bi-variate analysis, Chi-square test, and logistic regression analyses. were conducted using SAS. Results: The percentages of people diagnosed (treated) dental canes, periodontal disease. and temporomandibular joint disorder were 70.4(77.1), 16.1 (55.7), and 0.6(37.4), respectively. The reception of treatment for diagnosed dental caries and periodontal disease was significantly associated with older age, high monthly household income, and high education attainment. Logistic regression model indicated that age, monthly household income, education attainment, type of health insurance, and chewing problem were significantly associated with getting diagnosis and treatments of dental diseases. Most frequently answered reason for non - or delayed treatments of diagnosed dental diseases during the last one year was cost of treatments. Conclusions: The findings indicated that socio-economic-status still significantly affected reception of needed dental treatments among Korean adults despite the national health insurance system. Oral health policy and programs should be augmented to provide further support to adults of low socio-economic-status who are more prone to dental diseases yet lack resources for needed dental treatments.
The purpose of this study is to investigate determinants of the saving behaviors, perceptions of economic situation and attitudes on the program of the Individual Development Account program participants in Korea. Data used for this article was the survey on the participants of 'Seoul Hope-plus Saving Account Program' implemented by Seoul Welfare Foundation for 3 years. In order to consider variances within-individual and between-individuals, Hierarchical Linear model is used for this study. The results are as follows. First, In demographic factors, disability, gender, education level, marriage status are significant factors on the effectiveness of the program. Second, the participation on the program has positive effects on the conception on the living standard and economic status of the participants. However, total amount of savings excluding savings on 'Hope plus' has decreased. The household income is positively related with the amount of savings. Thus, it is necessary to consider individuals' socio-demographic factors to planning the asset-based program.
Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.
In this study, 1 have analyzed the state of the use of information technology by the at-risk children who are residing in Husan metropolitan area. The ultimate goal of this study is to help ensure the healthy development of the children and improve the quality of their lives in this information-oriented society. For this research, 1 surveyed 183 children living in an institution or a low-income family in Busan metropolitan area. The survey questionnaire was designed to obtain information on the respondents, socio-demographic characteristics, computer-related conditions of the immediate and social environments, patterns of computer and Internet use, their experience and degree of so called, Net-generation syndrome, Internet addiction disorder, changes in social and familial life caused by Internet use, and exposure to pornographic materials. The results show that 95.9 % of at-risk children in Husan own a computer, 60.9 % of those computers being Pentium Ⅲ. A majority of the children (74.9 %) are connected to Internet at a high-speed, using such devices as LAN, ADSL or cables. About seventy-six percent of the children have used a PC and Internet less than two years. In other words, a majority of them have not used those for a long period of time. The main results of the research are summarized in the following: There is a significant difference among at-risk children in terms of experiences in computer and Internet use according to their grade levels. There is a gender difference in the amount of time spent on computer and Internet. Boys spend more time every week on computer and Internet than girls do. There is a significant difference in the pattern of computer and Internet use, according to the type of their risk, and grade level. The so-called 'Net Generation Syndrome' is not serious in this group. A majority of the at-risk children think that Internet is more interesting than TV. They hardly shop on Internet, and they don think the advertisements on Internet are a serious problem. Also, unlike many people assumptions, their desire to communicate through on-line chatting was very low. They do not tend to buy computer game programs, and Internet Addiction Disorder was not pronounced among them. The at-risk children rarely had an exposure to pornographic materials in the cyber space. However, the exposure was more frequent for institutionalized children than children in low-income families. These results point to a need for a policy to improve the welfare of at-risk children and guarantee their right to information.
The incidence of cervical cancer has been gradually decreased since 1990, now it ranks the fourth most common carcinoma among Korean women in 2001. If squamous cell carcinomas in situ are included, the cervical cancer is still the most frequent tumor in Korean women. However, cervical cancer mortality in Korea has been decreased over the last 10 years in large part attributable to the introduction of the Papanicolaou test (Pap. test). The guidelines for the early detection of cervical cancer recommend women aged 30 and more to lake biennial screening with Pap. lest. According to the screening data of National Health Insurance Corporation (NHIC), 4,425 women (0.94%) showed an abnormal Pap among 473,395 cases tested in 2001; dysplasia was in 3,953 (0.84%) women, in situ carcinoma in 357 (0.075%) women, and invasive carcinoma in 115 (0.024%) women. The detection rates of abnormal Pap. were 4.21% in Korean Society for Cytopathology(KSC-2001), 1.37% (ASCUS : 0.26%, AGUS : 0.03%, LSIL : 0.45%, HSIL : 0.55%, Carcinoma 0.09%) in health check-up and 5.41% (ASCUS : 1.89%, AGUS . : 0.69%, LSIL : 1.39%, HSIL : 0.84%, Carcinoma : 0.64%) of patients in out-patient clinic without having history of cervical neoplasia at Hanyang University Hospital in 2002 Low rate of cervical cancer screening (34%) in Korea is mainly due to the lack of information for the Row income people regarding national cancer screening program. More adenuate budget by government and more man-power for precise screening, new guideline and system for management of the cervical cancer patients are required.
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.
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