J Korean Acad Oral Health.  2014 Dec;38(4):203-211. 10.11149/jkaoh.2014.38.4.203.

How does private health insurance affect dental care utilization?

• Kim SM
• Ahn E
• Shin H

• KMID: 2321461
• DOI: http://doi.org/10.11149/jkaoh.2014.38.4.203

Abstract

OBJECTIVES
This study discussed dental care utilization efficiency and equity from the perspective of private health insurance policy using the 2011 Korea Health Panel dataset.
METHODS
A total of 10,577 subjects, aged 20 years or older, were selected from a larger sample (N=18,256). The study conducted a two-part model analysis to determine the impact of private health insurance on utilization and amount of dental care.
RESULTS
Average monthly payment of private health insurance is 76,727 KRW. Analysis of average monthly fees and income distribution by quartile showed that higher income groups pay proportionally more for private health insurance. The highest income group was 3.82 times more likely to have private health insurance than the lowest income group. Those with private health insurance coverage had a higher probability of using dental care but were not more likely to use a greater number of dental services.
CONCLUSIONS
Based on these empirical findings, a guarantee of health care system and policy equity and efficiency should be established for changes in private health insurance.

Keyword

Delivery of health care; Dental care; Private health insurance; Two-part model

MeSH Terms

Dataset
Delivery of Health Care
Dental Care*
Fees and Charges
Income
Insurance, Health*
Korea

Figure

• 

  Fig. 1. Average monthly payments of private health insurance by household income quartile.

Reference

References

1. Baek IR, Park HS, Byeon SS. The determinants and medical care utilization behavior of private health insurance. Journal of Korea Contents Association. 2012; 12:295–305.

2. Yun HS. Effects of private insurance on medical expenditure. Korea Development Institute. 2008; 30:99–128.

3. Park SB, Jung KH. The determinants of private health insurance and its effects on medical utilization in Korea. Korean Social Security Studies. 2011; 88:23–49.

4. Lee CW. Implications for private health insurance of National Health Insurance profits. Seoul: KIRI;2014. p. 1–9.

5. Yoon TH, Hwang IK, Sohn HS, Koh KW, Jeong BG. The determinants of private health insurance purchasing decisions under national health insurance system in Korea: The expanding of private health insurance market, for the better or worse. Health Policy and Management. 2005; 15:161–175.

6. Jo HH, Kwon KH, Moon SH. Effects of private health insurance on health care utilization: a count data analysis. Korean Journal of Policy Analysis and Evaluation. 2010; 20:103–128.

7. Yoo CH, Oh EH, Kwon YD. The impact of having private health insurance on healthcare utilization with controlling for endo- geneity. The Korean Journal of Health Economics and Policy. 2010; 16:139–159.

8. Ku L. Medical and dental care utilization and expenditures under medicaid and private health insurance. Med Care Res Rev. 2009; 66:456–471.

9. Kim HJ, Lee JH. Factors associated with the middle-aged or the old-aged Koreans’enrollment in private health insurance. Journal of Korea Contents Association. 2012; 12:683–693.

10. Jun BY, Kwon SM. The effect of health care expenditure on the change in the demand for private health insurance in Korea. The Korean Journal of Health Economics and Policy. 2012; 18:65–84.

11. Yang DL, Choi IY, Kim KJ, Kwon YD. Awareness and purchase of the private dental insurance among dental patients in the capital region. Journal of Korea Contents Association. 2013; 13:322–332.

12. Hughes DC, Karen GD, Soobader MP, Newacheck PW. Disparities in children’s use of oral health services. Public Health Rep. 2005; 120:455–462.

13. Kim HK. The equity in health care utilization : a decomposition considering the type of health care providers. Social Science Studies. 2012; 28:205–226.

14. Lee HB, Nam SW. An empirical study of private health insurance and healthcare utilization. Korean Journal of Insurance. 2013; 95:1–24.

15. Buchmueller TC, Couffinhal A, Grignon M, Perronnin M. Access to physician services: does supplemental insurance matter? evidence from France. Health Econ. 2004; 13:669–687.

16. Chiappori PA, Durandb F, Geoffard PY. Moral hazard and the demand for physician services: first lessons from a french natural experiment. European Economic Review. 1998; 42:499–511.

17. Baek IR, Park HS, Byeon SS. A study on joining private health insurance of the socially vulnerable and medical service utilization of private insurance members. Health and Social Science. 2012; 31:127–151.

18. Yoo CH, Kang SW, Kwon YD. Individual characteristics associated with the market size change of private health insurance premium in Korea. The Korean Journal of Health Service Management. 2012; 12:165–177.

19. Sapelli C, Vial B. Self-selection and moral hazard in chilean health insurance. Journal of Health Economics. 2003; 22:459–476.

20. Yoo CH, Kang SW, Kwon YD, Oh EH. The effects of supplementary private health insurance on healthcare utilization and expenditures: indemnity vs fixed-benefit. Korean Social Security Studies. 2011; 27:277–292.

21. Ko SK, Kim JY, Yang BM. The effect of out-of-pocket price on ambulatory utilization. Korean Health Economic Review. 2002; 8:1–27.

22. Pizarro V, Ferrer M, Domingo-Salvany A, Benach J, Borrell C, Pont A, et al. The utilization of dental care services according to health insurance coverage in Catalonia (Spain). Community Dent Oral Epidemiol. 2009; 37:78–84.

23. Abraham D, Bronkhorst EM, Truin GJ, Felling A, Severens JL. How dental utilisation in the Netherlands was affected by a radical reform of the dental insurance system. Community Dent Health. 2003; 20:34–39.

24. Brennan DS, Anikeeva O, Teusner D. Dental visiting by insurance and oral health impact. Aust Dent J. 2013; 58:344–349.

25. Kim SM, Kwon YD. Private health insurance and the use of health care services: a review of empirical research in Korea. The Korean Journal of Health Service Management. 2011; 4:177–192.

26. Jung YH, Ko SJ, Lee LY, Jin DR, Kim SO, Han JT, et al. A report of Korea health panel survey 2008(Ⅰ). Seoul: Korea institute for health and social affairs;2009. p. 1–266.

27. Shin H, Song H, Kim J, Probst JC. Insurance, acculturation, and health service utilization among Korean-Americans. J Immigr Health. 2005; 7:65–74.

28. Lee YJ. Effects of private health insurance in national health care system. Journal of Korea Contents Association. 2014; 14:200–208.

29. Yang BM, Kim JH, Lee TJ, Bae EY. Health insurance. Yang BM, Kim JH, Lee TJ, Bae EY, editors. Health economics. 1st ed.Seoul: Nanam Publishing House;2013. p. 141–170.

30. Pohlmeier W, Ulrich V. An econometric model of the two-part de-cisionmaking process in the demand for health care. The Journal of Human Resources. 1995; 30:339–361.