An analysis of dental service items and dental fees in registered dentists / 대한구강보건학회지

OBJECTIVES: This study aimed to identify a relationship between dental service items and fees among dental clinics; this is important when deciding capitation rates for a registered system. The status of oral health, use of dental service items, and amount of dental fees for community care children were compared according to the dental clinics with which they were registered. The dental fees were analyzed using the oral health risk assessment components to identify the relationship between them. METHODS: The study subjects comprised 182 children from 8 community children centers in J district, S city, Gyeonggi-do. The independent variables were the dental clinics and the dependent variables were oral health status (decayed, missing, filled teeth [DMFT] index or df index), dental service items (total number of visits and dental filling type), and dental fees (total fees, National Health Insurance [NHI] coverage, and NHI non-coverage). The variables displayed a nonparametric distribution and were hence analyzed by the Kruskal-Wallis test. The nonparametrically distributed oral health risk assessment components were analyzed by the Mann-Whitney test. RESULTS: The higher the DMFT index, the higher the number of dental clinic visits and number of children with dental fillings. There were differences in the number of dental fillings between clinics except for resin-based fillings; this gap was wider for amalgam and gold inlay fillings. The dental fees differed between clinics and was probably dependent on the whether the major dental service type was NHI-covered or non-covered. "Anterior caries or restorations" in children with caries and "plaque retaining factors" in children with periodontal disease experience/plaque displayed statistically significant differences for total fees and NHI non-covered fees, respectively. CONCLUSIONS: The preference for specific service items leads to a difference in dental fees. It is essential to develop guidelines under a capitation agreement and practice them in order to achieve a successful registered dental system.

Clinical Evaluation on Treatment of Calcaneal Fractures / 대한정형외과학회잡지

Calcaneus is more frequently fractured than any other tarsal bones. Because of complex contour of calcaneus, it is difficult to evaluate the type of fracture exactyly. Futhermore fractures involving subtalar joint give rise to chronic pain and functional incapacity. Many different methods have been tried for treatment, but there was no aggrement of its methods and results. From January 1981 to December 1986, calcaneal fractures of 62 cases in 52 patients were analyzed and the results obtained from this study were as follows :l. Of 52 patients, 41 patients were male and 11 female. 2. The cause of fractures was a falling down in 38 patients (76%), traffic accident in 8 patients (15%) and direct blow in 6 patients (12%) 3. According to Rowe;s classfication, Type I fracture was in 5 cases, Type II in 6 cases, Type lll in 5 cases, Type IV in 12 cases and Type V in 34 cases (55%). Of these Type V fracture, tongue type was in 21 cases and joint depression type in 13 cases. 4. The treatment was as follows : cast immobilization in 33 cases, closed reduction and pin fixation in 24 cases and open reduction in 5 cases. 5. The functional result was satisfactory in 44 cases (71%). The result was better in fractures not involving subtalar joint and among type V fractures, the result was better in fractures of tongue type treated with open reduction. 6. So, we recommended compressive bandage and early mobilization for fractures without displacement, axial fixation for tongue type fractures and open reduction for joint depression type fracture.