Proposal and thoughts on establishing and improving multi-level dental insurance in China / 中华口腔医学杂志

Oral diseases are highly prevalent in China, while oral health services are generally underutilized and public health resources are wasted. Lacking oral insurance may be one of the leading causes. The basic medical insurance of China does not cover dental care in most cities, which is worthy to further discuss. To better understand the experience of dental insurance from international dental care practice, the dental coverage scope, content, co-pay ratio, and effects of oral insurance on oral health improvement from the abroad countries with typical health insurance systems were summarized by using scoping review. Then, we discussed the coverage scope for dental health of basic medical insurance and private insurance in China. We also analyzed the current issues of dental care coverage and cost-share. At last, we proposed thoughts and suggestions to establish and improve a multi-level oral health insurance system with Chinese characteristics under the basic medical insurance frame. In particular, we gave suggestions on increasing the coverage for high dental care xpenditure by ebasic medical insurance, supplying children and teenagers with preventive dental care, and encouraging private insurance companies to cover dental care expenditure.

La seguridad social: Un derecho y una obligación para el odontólogo y sus trabajadores / Social security: A right and obligation for the dentist and his workers

La seguridad social es un derecho encaminado a asegurar el bienestar de los ciudadanos que forman parte de una comunidad, y su objetivo principal es brindar a las personas aseguradas un conjunto de medidas públicas que ayuden a la protección de su salud por accidentes de trabajo o enfermedad laboral, desempleo, invalidez, vejez o muerte. De acuerdo con nuestra legislación, toda persona que preste servicios laborales a otro, tiene derecho a ser registrado ante el seguro social para que, en caso de accidente o enfermedad laboral, exista una ins- tancia que asista al trabajador afectado a recuperar su salud sin afectar su economía familiar. Es bastante frecuente que el odontólogo tenga trabajadores a su cargo, quien al fungir como patrón tiene obligaciones específicas ante el Instituto de Seguridad Social que de no cumplir, puede traer consigo sanciones y amonestaciones al profesional. El objetivo del presente artículo es informar al odontólogo sus derechos y obligaciones ante el seguro social mediante una revisión de las normas y leyes que lo imponen (AU)

Social security is a right aimed at ensuring the well-being of citizens who are part of community, and its main objective is to provide insured persons with a set of public measures that help protect their health, due to accidents at work and occupational disease, unemployment, disability, old age or death. In accordance with our legislation, any person who provides labor services to another has the right to registered with the social security so that, in the event of an accident or occupational disease, there is an instance that assists the affecter worker to recover his health without affecting his familiar economy. It is quite common for the dentist to have workers under his charge, who, acting as an employer, have specific obligations with the Social Security Institute, which, if not fulfilled, can bring sanctions and reprimands to the professional. The aim of this article is to inform dentists about their rights and obligations with the Social Security Institute through a review of the laws that impose it (AU)

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea

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.

The need for developing guidelines for radiation protection in dental institutions / 대한구강보건학회지

OBJECTIVES: The objectives of this study were to determine the radiation safety status of dental care institutions and to contribute to the development of guidelines for radiation protection in dental clinics in order to improve the work environment and reduce the radiation hazard for practitioners. METHODS: The subjects were selected using a convenience sampling. A total of 300 subjects participated in this study, including 150 dental hygienists from dental clinics in Gwangju Metropolitan City with radiation-related work experience and 150 dental hygienists who had participated in a seminar hosted by the Korean Dental Insurance Manager Association held on January 17, 2016. For the survey, self-entry questionnaires were used, and the collected data were analyzed by performing a frequency analysis using cross tabulation (χ2-test) and t-test, one-way analysis of variance, and multiple regression analysis. RESULTS: The awareness on radiation protection among dental hygienists showed 4.4 out of 5 points, which was high, but the practice of radiation protection was overall poor. For the necessity of developing radiation protection guidelines, 91.9% answered “Yes, it is necessary.”. CONCLUSIONS: The level of radiation protection practiced at dental healthcare centers was much lower than the awareness of it and showed that the requirement of guidelines for radiation protection was high. Therefore, institutional devices require the development and utilization of various types of radiation protection guidelines in order to mitigate radiation risks and improve the work environment.

Comparison of Factors Affecting Perceived and Objective Dental Needs / 치위생과학회지

BACKGROUND: With increased interest in oral health, several efforts have been made to improve oral health conditions. To achieve this, needs for oral health must be precisely determined and accurately measured. Therefore, factors influencing both objective unmet dental needs, which were determined by experts, and perceived unmet dental needs, which were determined by patients, were examined in this study. METHODS: Responses of 17,735 respondents aged greater than 19 years from the Korean National Health and Nutrition Survey collected using the fifth (2010~2012) rotation sample survey were analyzed. Based on the information collected from the survey and dental examination, we determined the associations between the independent (sex and socioeconomic level) and dependent variables using a chi-squared test. Moreover, ordinal logistic regression analyses on multiple categorical values were performed using perceived and objective dental needs as the dependent variables. RESULTS: Generally, factors influencing both perceived and objective dental needs were similar. These included sex, household income, educational level, private insurance, and subjective oral health status. However, the high-income groups had lesser perceived and objective dental needs compared to the low-income groups. Furthermore, factors such as sex, educational level, and marital status had different influence on both needs. CONCLUSION: Generally, factors that affect perceived and objective dental needs were similar. To minimize unmet dental needs, factors influencing both perceived and objective dental needs should be examined for a broad dental insurance coverage, and efforts to prevent oral diseases are also required.

Factores asociados a la utilización de servicios de salud odontológicos / Factors associated with the use of dental health services

Resumen El presente trabajo se propone analizar los factores asociados a la utilización de servicios de salud odontológicos (USSO) en individuos adultos de la Ciudad de Corrientes; Argentina. Se realizó un estudio transversal. A través de una encuesta domiciliaria se recolectó información de las variables de estudio. Se determinó el tamaño de la muestra estableciéndose un nivel de confianza del 95% (381 individuos). Se aplicó un diseño muestral aleatorio simple, que se complementó con un muestreo no probabilístico por cuotas. Se analizaron los datos con los programas SPSS 21.0. y Epidat 3.1. El nivel socioeconómico, la cobertura social odontológica, la percepción sobre la salud bucal, los conocimientos de salud bucal y los hábitos de higiene bucal se asociaron significativamente a la USSO en los últimos 12 meses. Los mismos factores, a excepción de la cobertura social odontológica y de los conocimientos de salud bucal, se asocian a la USSO por motivos de control/chequeo dental de rutina. Se deben implementar medidas tendientes a aumentar la USSO con fines de prevención en individuos de ambos sexos, de todos los niveles socioeconómicos, especialmente en aquellos menos favorecidos.

Abstract This paper seeks to analyze the factors associated with the use of dental health services (UDHS) by adults in the city of Corrientes, Argentina. A cross-sectional study was conducted. Information concerning the study variables was collected via a home survey. The sample size was established with a 95% confidence interval level (381 individuals). A simple random sampling design was used, which was complemented with a non-probability quota sampling. The data was analyzed using SPSS version 21.0 and Epidat version 3.1 softwares. Socio-economic level, dental health coverage, perception of oral health care, perception of oral health, knowledge about oral health, and oral hygiene habits were significantly associated with the UDHS over the last twelve months. These same factors, excluding dental health coverage and knowledge about oral health, were associated with the UDHS for routine dental check-ups. Measures should be implemented to increase the UDHS for prevention purposes in men and women of all socio-economic levels, particularly in less-privileged individuals.

Private dental insurance expenditure in Brazil / Gastos privados com planos exclusivamente odontológicos no Brasil

ABSTRACT OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008-2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population.

RESUMO OBJETIVO Quantificar as despesas domiciliares per capita e estimar o percentual de domicílios brasileiros que gastaram com planos exclusivamente odontológicos. MÉTODOS Foram analisados dados de 55.970 domicílios que participaram da Pesquisa de Orçamentos Familiares em 2008-2009. Os gastos domiciliares anuais per capita com planos exclusivamente odontológicos (empresarial e particular) foram analisados segundo os estados da federação e as características socioeconômicas e demográficas dos domicílios (sexo, idade, cor da pele e escolaridade do chefe do domicílio, renda familiar e presença de idoso no domicílio). RESULTADOS Apenas 2,5% dos domicílios brasileiros relataram gastos com planos exclusivamente odontológicos. O valor per capita despendido somou em média R$5,10, sendo a maior parte composta por planos odontológicos particulares (R$4,70). Entre as caraterísticas do domicílio, maior escolaridade e renda estiveram associadas com maior gasto. São Paulo foi o estado com maior gasto domiciliar per capita (R$10,90) e maior prevalência de domicílios com dispêndios (4,6%), enquanto Amazonas e Tocantins apresentaram os menores valores, ambos com gasto inferior a R$1,00 e com menos de 0,1% de domicílios, respectivamente. CONCLUSÕES Apenas uma pequena parcela dos domicílios brasileiros desembolsa com planos exclusivamente odontológicos. O mercado de odontologia suplementar na assistência em saúde bucal abrange uma restrita parcela da população brasileira.

Relações e conflitos no âmbito da saúde suplementar: análise a partir das operadoras de planos odontológicos / Relationships and conflicts within the health insurance sector: analysis from dental insurance companies

Resumo Este estudo de abordagem qualitativa teve como objetivo compreender as relações e conflitos entre operadoras odontológicas, beneficiários e prestadores, além da interface com a Agência Nacional de Saúde Suplementar (ANS) e com o Sistema Único de Saúde (SUS). A coleta de dados foi realizada mediante a aplicação de questionários aos representantes das operadoras, seguida de análise documental e de entrevistas semiestruturadas. A análise por meio da triangulação dos dados permitiu observar como principais resultados: que a lógica de redução de custos orienta as ações das operadoras e se reflete nas relações com beneficiários, prestadores e ANS; que é frágil a interface com o SUS; que há resistência à ampliação de coberturas; e que o crescimento do mercado é acompanhado de grande concentração. Não se pode ignorar a pujança da saúde suplementar na odontologia, mas é preciso discutir criticamente o papel do Estado, tanto como regulador deste mercado, quanto como indutor de um modelo de atenção à saúde bucal com maior qualidade e resolutividade.

Abstract This study of a qualitative approach aimed to understand the relationships and conflicts between dental insurance companies, beneficiaries, and providers, as well as the interface with the National Supplementary Health Agency (ANS) and the Unified Health System (SUS). Data was collected through questionnaires applied to representatives of selected companies, documentary analysis and semi-structured interviews. The analysis through data triangulation enabled to observe as main results: cost control mechanisms guides the companies' activities and also perpetrate the relations with beneficiaries, providers and the ANS; there is a poor relation with the SUS; the companies tend to avoid the extending of dental insurance coverage; and the dental insurance market comes with huge concentration. We cannot ignore the strength of the dental health insurance sector in Brazil, but it is necessary to critically discuss the role of the State, both as regulating the private insurance sector as encouraging a dental care approach with improved quality and resolutivity.

Profile of the adult population of the city of Corrientes (Argentina) in relation to dental health insurance

Objective: to characterize the adult population of the city of Corrientes (Argentina) in relation to dental health insurance according to sociodemographic and dental variables. Materials and Methods: A descriptive cross-sectional study was conducted in the city of Corrientes (Argentina). Information regarding the study variables was collected through the application of a structured survey. Sample size was determined by establishing a 95 percent confidence level (381 subjects between 35 and 44 years of age). The direct face-to-face observation technique was used for data collection. A simple random sample design was applied for the selection of the homes to be surveyed, which was complemented by a non-probabilistic sampling using quotas for the selection of the individuals to be interviewed from the 2010 Population Census data. Results: Of the total of the participants, 56.4 percent had dental health insurance. Health insurance was significantly associated with a higher socioeconomic level OR: 1.90 (95 percent CI 1.26-2.87, p=0.01); greater probability of having had a consultation in the 12 months prior to the interview OR: 1.74 (95 percent CI 1.13-2.68, p=0.01), going to the dentist for dental treatments OR: 1.5 (95 percent CI 1.02-2.43, p=0.03), or because of pain or an emergency problem OR: 1.59 (95 percent CI 1.05- 2.42, p=0.02), and presenting better oral hygiene self-care. Conclusions: There are oral health inequities in the adult population of the city of Corrientes (Argentina). Having dental health insurance is associated with a higher socioeconomic level, having more frequent dental consultations to get dental treatment and in emergency situations, as well as presenting better oral hygiene self-care.

Factors Related to the Unmet Dental Care Needs of Adults with Dental Pain / 치위생과학회지

The purpose of this study was to examine unmet dental care needs and related factors among adults in Korea. The study included a nationally representative sample of Koreans (Korea National Health and Nutrition Examination Survey 2104). The dependent variable was unmet dental care need and the independent variables were socioeconomic status and oral health status. The chi-square test and logistic regression analysis were performed to identify the associations between explanatory variables and unmet dental care needs. The major causes of unmet dental care needs included economic burden, work life, and academic reasons; in addition, dental treatment was considered to have lower priority. The factors that had statistically significant relationships with unmet dental care needs were sex, age, self-rated oral health status, and difficulty in mastication. The findings of the study, suggest a need for lower dental insurance copayments in keeping with the policies and principles aimed at strengthening the national health insurance system. In addition, groups with limited access to dental services should be identified, and effective health care policies and services should be established for these individuals.

Oral health quality of the workers of a telemarketing company and their satisfaction with the treatments provided by the corporative dental insurance plan

Aim: To evaluate the oral health quality of the workers of a telemarketing company and their satisfaction with the dental treatments provided by the corporative dental insurance plan. Methods:Data collection was by an online intranet questionnaire on dental service providers from Uberlândia/MG and Campinas/SP. It was addressed to 6000 associates, with objective and subjective questions, comprising the level of the telemarketing operators’ oral health, dental needs, satisfaction with dental care providers and the importance of having the laboral dental services provided by the company. Results: After analysis of the results, we observed that:57.52% of the workers required improvement in their oral health and 56.03% mentioned prevention as the largest need, 66.70% use the dental providers’ services, but only 31.34%were satisfied with them. Conclusions: The results underscore that the workers have anintermediate level of dental needs, with prevention as top importance. Additionally, establishment of a basic attention program inside the company would increase the satisfaction and adhesionindexes of providers and the workers’ oral health.

The dental professional after productive restructuring: ethics, the job market and dental public health / O profissional da odontologia pós-reestruturação produtiva: ética, mercado de trabalho e saúde bucal coletiva

Objective: to uncover ethical problems in dental professionals' new labor reality after productive restructuring. Methods: exploratory and descriptive qualitative research, carried out through an individual, semi-structured interview with 10 dental professionals within a universe of 30 interviewees. The analysis method was Textual Discourse Analysis. Results: 1. Ethical problems in the dental job market after the productive restructuring: the new reality of health plans, private health insurance and popular clinics does not seem to meet the professionals' needs; rather, it seems to meet the needs of the market, entailing diversified ethical problems. A growing inter-peer resentment seems to be directly related to the crisis in the job market and to transforming the old concurrence into competitiveness; and 2. Transformations in dental public health: it debates the social need constructing excellence in public health dentistry as an ethical problem, different from the logic of the market. Conclusion: a professional crisis points at different ethical problems: transformations in the job market strengthen a commercial sense in the profession, building business configurations with increased capital accumulation in realities of precarious labor; the exclusive action of the dental public health professional stimulates his leading role in transformations towards a new professional excellence: that of the public service. .

O objetivo deste artigo é desvelar os problemas éticos na nova realidade de trabalho dos profissionais da odontologia, pós-reestruturação produtiva. Pesquisa qualitativa do tipo exploratório descritivo realizada por meio de entrevista individual semiestruturada com dez profissionais da odontologia num universo total de 30 entrevistados, utilizando o método de análise textual discursiva. O mercado de trabalho da odontologia pós-reestruturação produtiva apresenta uma nova realidade de planos, convênios e clínicas populares que não atende às necessidades dos profissionais em vários quesitos, mas, sim, às suas próprias necessidades comerciais, ocasionando diversificados problemas éticos. Um crescente ressentimento interpares parece ter relação direta com a crise neste mercado de trabalho e com a transformação da velha concorrência liberal em competitividade. Diferenciada da lógica de mercado, as transformações na saúde bucal coletiva direcionam a um importante e contemporâneo debate: a necessidade social de construção da excelência para a odontologia pública como problema ético. Conclui-se que uma crise profissional na odontologia aponta diferentes problemas éticos, uma vez que as transformações no mercado de trabalho reforçam um sentido comercial na profissão, construindo configurações empresariais com ampliação de acumulação de capital em realidades de precarização no trabalho; e que a ação exclusiva do profissional na saúde bucal coletiva estimula o seu papel protagonista nas transformações rumo a uma nova excelência profissional pública.

Factors influencing oral insurance among children in Chengdu / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the value of child oral health for Chengdu parents, their intentions, and factors influencing their decision to acquire oral insurance coverage for their childrens.</p><p><b>METHODS</b>A total of 562 Chengdu parents were interviewed using questionnaires by convenient sampling, and the results were analyzed using SPSS 20.0.</p><p><b>RESULTS</b>The age of children (B = -1.741, P = 0.004), age of parents (B = 2.031, P = 0.003), level of oral discomfort (B = 0.569, P = 0.000), incurring/not incurring oral care expenses in the previous year (B = 1.897, P = 0.014), the last time parents' had teeth cleaned (B = 0.777, P = 0.006), and acquiring/not acquiring commercial insurance coverage (B = 1.632, P = 0.031) significantly influenced the intention of acquiring child oral insurance.</p><p><b>CONCLUSION</b>Child oral health, health and insurance awareness of parents, and other factors influenced the intention of parents to purchase oral insurance coverage for their children, which were significant to establish pediatric dental insurance.</p>

Administrative and clinical denials by a large dental insurance provider

The objective of this study was to assess the prevalence and the type of claim denials (administrative, clinical or both) made by a large dental insurance plan. This was a cross-sectional, observational study, which retrospectively collected data from the claims and denial reports of a dental insurance company. The sample consisted of the payment claims submitted by network dentists, based on their procedure reports, reviewed in the third trimester of 2012. The denials were classified and grouped into ‘administrative’, ‘clinical’ or ‘both’. The data were tabulated and submitted to uni- and bivariate analyses. The confidence intervals were 95% and the level of significance was set at 5%. The overall frequency of denials was 8.2% of the total number of procedures performed. The frequency of administrative denials was 72.88%, whereas that of technical denials was 25.95% and that of both, 1.17% (p < 0.05). It was concluded that the overall prevalence of denials in the studied sample was low. Administrative denials were the most prevalent. This type of denial could be reduced if all dental insurance providers had unified clinical and administrative protocols, and if dentists submitted all of the required documentation in accordance with these protocols.

Perfil epidemiológico de salud bucal en niños atendidos en el Seguro Social del Perú / The epidemiological profile of oral health in children treated in the Social Security of Peru

Determinar el perfil epidemiológico de salud bucal en niños de 3 a 5 años y 12 años de edad que se atendieron por primera vez y a nivel nacional en el Seguro Social del Perú durante el año 2.013. Material y Métodos: el estudio fue de tipo descriptivo transversal y se llevó a cabo en las 28 Redes Asistenciales del Seguro Social del Perú (ESSALUD) con una muestra de 6.975 niños de 3 a 5 años y 2.375 niños de 12 años de edad. Resultados: se observó que la prevalencia de caries dental en los niños de 3 a 5 años fue del 79,8%; mientras que en los de 12 años fue del 90,4%%, siendo el ceo-d y COP-D hallados de 4,57 (DS: 3,1) y 4,98 (OS: 2,7) respectivamente. Asimismo, se determinó que el número de piezas dentarias afectadas por la caries dental representó el 22,7% del total de dientes primarios y el 17,7% del total de dientes permanentes evaluados. Conclusiones: los resultados obtenidos nos demuestran la necesidad de mejorar la cobertura de atención odontológica en el Perú con una visión integral en el cuidado de la salud bucal desde edades tempranas; así como, priorizar políticas públicas sanitarias que optimicen las estrategias implementadas; a fin de revertir de manera sostenible el alto índice de caries dental en los niños peruanos...

To determine the epidemiological profile of oral health in children from 3-5 years old and 12 years old who were treated for the first time nationwide in the Social Security of Peru in 2013. Methods: The studies were carried out as both descriptive and cross-sectional in the 28 Social Security Assistance Networks of Peru (ESSALUD) with a sample of 6,975 children aged 3-5 years old and 2,375 children 12 years of age. Results: It was observed that the prevalence of dental caries in children aged 3-5 years was 79.8%; whereas in 12 years was 90.4%, the ceo-d and COP-D found were 4.57 (DS: 3,1) and 4.98 (DS: 2,7) respectively. It was also determined that the number of teeth affected by caries represented 22.7% of primary teeth and 17.7% of all permanent teeth evaluated. Conclusions: The results show us the need to improve the coverage of dental care in Peru with a comprehensive insight into the oral health care from an early age; as well as prioritize public health policies that optimize the strategies implemented to sustainably reverse the high rate of dental caries in peruvian children...

An analysis of oral health status, dental service items, and fees among children receiving care from registered dentists over a three-year period / 대한구강보건학회지

OBJECTIVES: This study aims to investigate the trends and progress in oral health status, dental service items, and fees among children receiving community-based registered dental care over a three-year period. METHODS: The study subjects were selected from nine community children centers in J district of S city, in the Korean province of Gyeonggi-do. The sample included 222 children who had received care in 2011 and 2012, and 205 children, in 2013. The dependent variables were oral health status (df index and decayed-missing-filled teeth index), dental service items (total number of visits and dental fillings by type), and dental fees (total fees, National Health Insurance [NHI] coverage, and NHI non-coverage), analyzed by year. The percentages of dental caries and dental service items were tested using chi-square analysis, and the mean of each variable, including dental fees, was tested using the Kruskal-Wallis method, owing to non-parametric distribution. RESULTS: There was a statistically significant decrease in the rate of dental clinic visits for treatment, and an increase in the mean numbers of filled teeth and sealants performed per year. The rate and number of dental fillings increased steadily, whereas the services for oral health promotion and prevention were decreased. The number of dental visits and the total fees decreased steeply, especially within the second half of the last measured year: around 90,000 earned within that time, compared to 170,000 earned during the first year. CONCLUSIONS: Dental clinic visits should be encouraged on a regular basis for oral health promotion and prevention by both patients and providers using capitation payment systems, for example. It is necessary to monitor and provide training for all related staff by developing a manual for oral health examination and treatment, adjusted for the registered dental system. Policy measures addressing the needs of vulnerable social groups are needed more than ever. Therefore, it is important to provide as much targeted support and training to the registered dental system as possible.

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.

Convênios odontológicos: visão dos cirurgiões-dentistas do Município de Duque de Caxias/RJ / Dental private insurance: vision of The dentists of the city of Duque de Caxias/RJ

O objetivo do presente estudo foi a partir de uma abordagem indutiva, utilizando um questionário fechado nos consultórios dentários que atendem a convênios odontológicos no município de Duque de Caxias (RJ), fazer o levantamento do perfil de relacionamento técnico-profissional entre esses profissionais e as empresas de Planos de Saúde Odontológicos. Dos 74 questionários respondidos, observou-se uma distribuição homogênea de 20% quanto ao tempo de formado, em cada faixa de tempo. O atendimento a mais de um plano de saúde se mostrou mais comum (88% da amostra). O aumento de volume de pacientes se destacou entre os pontos positivos (81%) e falta de clareza, quanto a valores diferenciados entre colegas (89%) e falta de reajuste financeiro e ou pagamento não compatível com o mercado (52%) como principais pontos negativos.

The aim of this study was an inductive approach through a close questionnaire applied in private dental offices that offer dental pre-payment assistance, in order to analyse the working relationship between dentists and private dental insurances in the City of Duque de Caxias (RJ). A sample of 74 questionnaires, were equally distributed (20% each), by graduation time. The attendance to more than one pre-payment oral health company insurance was the most common (88% of the sample). From the positive aspects, the patients increase were most mentioned (81%) and the lack of clarity about the different values paid between colleagues (89%) and lack of financial adjustment or payment not compatible with the market (52%) as the main negative points.