The baseline study for insurance coverage of preventive treatment item on Korea National Health Insurance

예방치과 진료항목 보험급여 방안에 대한 연구

Kwon, Ho-Keun;Choi, Youn-Hee;Choi, Chung-Ho
권호근;최연희;최충호

  • Published : 20020900

Abstract

This study was performed to develop the preventive treatment item on Korea national health insurance by a national mailing questionnaire survey of 2,000 private dentists who was selected from 2000 Korean Dental Association members list by random sampling method. Collected 236 questionnaires were analyzed and the results are as follows: 1. The 39.6% dentists did not perform Topical Fluoride treatment and the 29.5% dentists answered that Topical Fluoride had no effect and patients didn't want it. The mean numbers of treated patients per week was 2.25. The frequency of reapplication among treated patients was 1.70 times per year, the mean treatment time was 9.91 minutes, and the mean treatment fee for each arch was 16,181 won. Adequate insurance fee of topical fluoride treatment for each arch was investigated as 21,212won. 2. The 89.7% dentists answered that they demonstrated Tooth Brushing Instruction(TBI). The 38.0% answered they did not demonstrate the TBI because there was no coverage by national health Insurance. The mean numbers of TBI patients each week was 10.2, the mean teaching time was 6.86 minutes for each patient, and the 64.0% dentists answered that dental hygienists demonstrated TBI in their dental clinics. The TBI average price was 12,727 won, and they answered if there is an insurance coverage, the most adequate average price was 9,850 won. 3. The 94.8% dentists answered that they applied the dental sealants and the 37.5%answered they did not apply the sealants because there was no coverage by Korean Health Insurance. The mean numbers of sealant patients each week was 5.53 and the 77.1% answered that most dentists applied the sealants for patients, The mean applying time was 7.42 minutes and the average price was 28,312 won, They answered if there is an insurance coverage, the most adequate average price was 24,719won. 4, The 75.6% dentists answered that they performed the oral prophylaxis and the 55.5% answered that they did not perform the oral prophylaxis because there was no coverage by Korean Health Insurance, The mean numbers of oral prophylaxis patients each week were 6.71, and the 53.4% dentists answered that dental hygienists performed the oral prophylaxis in their dental clinics, The mean performing time for each patient was 22,6 minutes and the average price was 44,888won, The most adequate average price they answered was 37,354 won. 5, Based on the effectiveness study of each preventive dentistry treatment lists and the results of this questionnaire survey, we decided priority ranking to preventive treatment lists: Dental Sealants(l), TBI(2), Topical Fluoride Application(3), and Oral Prophylaxis(4).

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References

  1. Gluck GM, Morganstein WM. Jong' s Community Dental Health. fourth ed, St. Louis:Mosby-Year Book; 1998:53-72
  2. 의료보험연합회, 분야별 비교조사. 서울:의료보험연합회;1993
  3. 유승흠, 김한중, 조우현, 손명세, 박은철. 의료보험 수가구조개편을 위한 3차 연구. 서울:연세대학교 보건정책 및 관리 연구소;1999
  4. Centers for Disease Control and Prevention. Preventive Services Task Force Guide to clinical preventive services: An assessment of the effectiveness of 169 interventions. U.S.: Lippincott Williams & wilkins; 1989:395-396
  5. Thylstrup A, Fejerskov O. Textbook of Clinical cariology, 2nd Ed. Copenhagen:Munksgaard; 1994:259-278
  6. Clark DC, Hanley JA, Stamm JW, Weinstein PL.An empirically based system to estimate the effectiveness of caries-preventive agents. Caries Res 1985;19(1):83-95 https://doi.org/10.1159/000260833
  7. Hansen I, Foldspang A, Poulsen S. Use of a national database for strategic management of municipal oral health services for Danish children and adolescents. Community Dent Oral Epidemiol 2001 ;29(2):92-8 https://doi.org/10.1034/j.1600-0528.2001.290203.x
  8. Marray JJ. The prevention of oral disease. New York: Oxford university press;1996:68-77
  9. 김종배, 백대일, 문혁수 외 11인. 임상예방치과학. 3판. 서울:고문사;2000:333
  10. 서울의대 의료관리학교실. 바람직한 건강보험 재정 운영 방안 마련을 위한 간담회 참고자료. 서울: 서울의대 의료관리학교실;2000
  11. 건강사회를 위한 치과의사회. 구강병 예방진료의 보험급여 확대를 위한 정책 토론회. 서울:건강사회를 위한 치과의사회;2000:11-33