J Periodontal Implant Sci.  2016 Dec;46(6):405-414. 10.5051/jpis.2016.46.6.405.

Changes in dental care access upon health care benefit expansion to include scaling

• Park HJ
• Lee JH
• Park S
• Kim TI

• KMID: 2362906
• DOI: http://doi.org/10.5051/jpis.2016.46.6.405

Abstract

PURPOSE
This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level.
METHODS
A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed.
RESULTS
Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits.
CONCLUSIONS
The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

Keyword

Dental health services; Dental scaling; Health policy; Health services accessibility; Insurance benefits; Periodontal diseases

MeSH Terms

Adult
Delivery of Health Care*
Dental Care*
Dental Health Services
Dental Scaling
Education
Health Policy
Health Services Accessibility
Humans
Insurance Benefits
Korea
National Health Programs
Periodontal Diseases

Figure

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  Figure 1 Percentage of adults aged 19 to 64 years who needed but did not receive dental care in the past year, showing the difference before and after the scaling coverage expansion. A, pre-policy period data (2010, 2012); B, post-policy period data (2014). a)Statistically significant difference (P<0.001).

• 

  Figure 2 Percentage of adults aged 19 to 64 who had at least 1 visit for preventive dental care, including scaling, sealant, and fluoride varnish, in the past year, showing the difference before and after the scaling coverage expansion. A, pre-policy period data (2010, 2012); B, post-policy period data (2014). a)Statistically significant difference (P<0.001).

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