J Periodontal Implant Sci.  2019 Aug;49(4):248-257. 10.5051/jpis.2019.49.4.248.

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

• Seo H
• Lee BA
• Lim H
• Yoon JH
• Kim YT

• KMID: 2455802
• DOI: http://doi.org/10.5051/jpis.2019.49.4.248

Abstract

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.

Keyword

Dentures; Dental implants; Health insurance; Insurance benefits; Health services for the aged

MeSH Terms

Aged*
Anemia
Arthritis, Rheumatoid
Asthma
Cerebral Infarction
Cohort Studies*
Dental Caries
Dental Implants
Denture, Complete
Denture, Partial, Removable
Dentures
Health Services for the Aged
Humans
Hypertension
Insurance Benefits
Insurance Coverage
Insurance, Dental
Insurance, Health*
Korea*
National Health Programs
Osteoporosis
Periodontal Diseases
Prevalence
Retrospective Studies
Dental Implants

Figure

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  Figure 1 Flowchart of the selection and analysis of patients from the National Health Insurance Service database.

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  Figure 2 Numbers of patients receiving insurance benefits for oral rehabilitation.

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