RESUMO
Objectives@#Korea’s National Health Insurance (NHI) coverage rate for dental services is 16.0%, far lower than the 33.0% average of OECD (Organization for Economic Co-operation and development) countries. In 2013, the government implemented a policy to pay for dental scaling service for adults over the age of 20. Then in 2017, the eligibility criteria was expanded to adults aged 19 or older the eligibility age was lowered expanded to 19 or older. @*Methods@#The study aimed to determine the effectiveness of the policy by comparing the number of times per person the dental scaling service was used before and after the implementation of the new applicants group compared to the existing application/applicants group. The analysis was conducted among patients aged 19 and 20 who visited the hospital with gingivitis and periodontal disease and who used the dental scaling service more than once per year as a preventive measure, using the customized database of the NHIC (National Health Insurance Corporation). As of July 1, 2017 when the dental scaling service was implemented by the National Health Insurance Service, the period was set as “before enforcement” (January 2016 to June 2017) and “after enforcement” (July 2017 to December 2018). To evaluate the policy effectiveness of expandingthe ages of individuals eligible for the dental scaling service, Difference-in-Differences (DiD) analysis was conducted to examine the number of times per person the service was used, changes in personal contributions, and policy effectiveness. @*Results@#Since the National Health Insurance policy to pay for dental scaling services, both the applicants group and the sustainable application group have increased the rate of inspection of preventive dental scaling services (19.82%→30.91%, 29.68%→31.18%). As a result of determining the pure effect of the NHI’s policy of covering the dental scaling service, it was found that the the number of times the dental scaling service was used per person increased significantly in the new application group (0.03 times, <.0001). @*Conclusions@#However, it was found that the cost of the dental scaling service per person while the cost of the dental scaling decreased was shown to decrease, it was not statistical significant. Therefore, additional policy support such as lowering the personal financial burden is needed for those who are unable to afford the service.
RESUMO
Objectives@#The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. @*Methods@#Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. @*Results@#The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. @*Conclusions@#In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.
RESUMO
Objectives@#The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. @*Methods@#Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. @*Results@#The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. @*Conclusions@#In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.