The Effects of National Health Insurance Denture Coverage Policies for the Elderly on the Unmet Dental Needs of the Edentulous Elderly / 치위생과학회지

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.

Cost Analysis for Dentures Performed at Dental Clinics in Korea / 보건행정학회지

BACKGROUND: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. METHODS: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. RESULTS: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. CONCLUSION: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.

Oral health-related quality of life improvements and satisfaction in South Korea: results from the National Health Insurance Coverage Denture Project for the Elderly / 대한구강보건학회지

OBJECTIVES: In this study, we assessed the effects of the National Health Insurance Coverage Denture Project for the Elderly on the improvement of oral health-related quality of life (QOL) and satisfaction. METHODS: Individuals aged > or =75 years (n=121) participated in the project at dental clinics or public health centers in Busan City, South Korea. Baseline and post-intervention follow-up surveys (personal interview) were conducted between October 2013 and April 2014. RESULTS: Significant improvements were demonstrated in all seven Oral Health Impact Profile-14 (OHIP-14) subscales at follow-up. Functional limitation showed the most improvement (2.81 points) followed by physical functionality, physical pain, psychological discomfort, social isolation, mental function, and social function. In addition, participants with no income who were required to pay for their expenses, reported higher satisfaction. The multiple logistic regression analysis showed that the rate of improvement on the OHIP-14 ten score increased in cases where participants who had to pay for their expenses (odds ratio [OR], 2.98; 95% confidence interval [CI]: 1.16, 7.66) but decreased for patients who received partial dentures (OR, 0.34; 95% CI: 0.13, 0.89), patients who expressed previous satisfaction with denture costs (OR, 0.37; 95% CI: 0.14, 0.97), and patients who had previous denture experience (OR, 0.43; 95% CI: 0.16, 1.12). CONCLUSIONS: Despite the short period (2 years), the National Health Insurance Coverage Denture Project for the Elderly was able to demonstrate significant improvements in oral health-related QOL. Therefore, the establishment and integration of this project is recommended to maintain and improve the QOL for the rapidly aging population.