Graduate School of Dental Hygiene, Yonsei University1
Department of Preventive Medicine, Wonju College of Medicine, Yonsei University2
Department of Dental Hygiene, Wonju College of Medicine, Yonsei University3
Objectives: The purpose of this study was to investigate the changes in factors on unmet dental scaling rate before and after the national health insurance. Methods: This study used the 2nd data from the Community Health Survey. The study participants numbered 209,341 in 2011 and 219,517 in 2013.The average age was 51± 17 in 2011 and 52 ± 17 in 2013. Data were analyzed by descriptive statistics, chi -squared test and logistic regression using SPSS 23.0. Results: The scaling experienced rate of Korean adults has fallen by 3.5% from 66% to 69.5%. Logistic regression analysis showed that 2.7 times more 'people who were educated at elementary school level or lower' did not use dental scaling compared to higher educated children. Agriculture, forestry and fisheries workers did not use scaling at 2.0 times. Local residents with an income of less than one million won did not use 1.7times scaling. Local residents of 'no private insurance' did not use scaling at 1.5 times. In the case of the predisposing factors, the 20s had less than 1.8 times scaling compared to 50s. In the case of needs factor, local residents who experienced 'bad oral health status' and 'dental calculus' were treated scaling 1.3 times less compared to people with good oral health status and normal periodontal symptoms. Conclusions: In Korea, local residents are less frequently treated scaling due to enabling factors such as accessibility. In addition, predisposing factors such as age and sex, and oral health status and periodontal symptoms were related to not using the dental scaling. Therefore, the universality of health care services should be considered so that people who need periodontal care can use scaling.
1. Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: The national health insurance service -national sample cohort (NHIS-NSC), South Korea. Int J Epid 2016:dyv319.
2. Kim SJ, Huh SI. Financial burden of health care expenditures and unmet needs by socio-economic status. Korean Health Econ Rev 2011;17(1):47-70.
3. Kang HJ. Current state and challenges of national health insurance. Health and Welfare Forum 2016;231(1):15-30.
4. Choi HM. National health insurance coverage for implant and denture. J Korean Dent Assoc 2016;54(6):457-67.
5. Kim JH. Objective dental care unmet needs and associated factors: Implications for national health insurance benefit package. J Korean Acad Dent Insurance 2013;4(1):1-11.
6. Livingston M, Parsell D, Pollack S. Periodontal disease: systemic risk factors. J Correct Health Care 2002;9(3):247-55.
7. Page RC, Schroeder HE. Pathogenesis of inflammatory periodontal disease. A summary of current work. Laboratory investigation. J Technical Methods and Pathology 1976;34(3):235-49.
8. Ximenez-Fyvie LA, Haffajee AD, Som S, Thompson M, Torresyap G, Socransky SS. The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota. J Clin Periodontol 2000;27(9):637-47.
9. Lee YM. Health policy for the people. J Korean Med Assoc 2017;60(4):286-8.
10. Kang HJ. Policy directions for the national health insurance for 2017: Harmonizing equity and efficiency through innovation. Health and Welfare Forum 2017;243(1):18-28.
11. Kim YT, Lee JH, Kweon HI, Lee JS, Choi JK, Kim DW, et al. Evaluation of national health insurance coverage of periodontal scaling : A nationwide cohort study in Korea. J Korean Dent Assoc 2016;54(8):604-12.
12. Jang YE, Lee MY, Park SK, Kim YJ, Lee GY, Kim CB, et al. A 7-year study of the regional distribution of differences in scaling experience rate among Koreans. J Korean Acad Oral Health 2015;39(3):201-6.
13. Heo YM. Factors affecting the national health insurance dental scaling experience based on anderson's model. Graduate school of public health science [Master's thesis]. Songnam: Univ. of Eulji, 2015.
14. Song TM. An anderson model approach to the mediation effect of stress-vulnerability factors on the use of outpatient care by the elderly. Health Soc Welf Rev 2013;33(1):547-76.
15. Cho HA, Heo YM, Kim HJ, Choi ES. Association of self-perceived oral health and depression in the elderly: the sixth korea national health and nutrition examination survey(the 6th KNHANES). J Korean Soc Dent Hyg 2016;16(2):285-93.
16. Choi ES, Kim MN, Noh SM, Park EJ. Factor affecting dental service utilization of adult: An application of the andersen model. J Korean Soc Dent Hyg 2015;15(1):67-76.
17. Andersen R. A behavioral model of families' use of health services. Research Ser 1968;(25): xi+111.
18. Kim YS, Park BH, Lee HY. A Study on predicting health literacy of Korean elderly using Andersen's health behavior model. J Welfare for the Aged 2014;65(0):35-57.
19. Ainamo J, Barmes D, Beagrie G, Cutress T, Martin J, Sardo-Infirri J. Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J 1982;32(3):281-91.
20. Korea Laws. Medical Law. [Internet]. [cited 2017 Apr 15]. Available from: http://www. law.go.kr/lsInfoP.do?lsiSeq=193394&efYd=20170418#0000
21. Jeon BJ, Han AK. Predictors of social service utilization of elderly using the anderson model. J Digital Convergence 2014;12(8):19-27.
22. Choi ES, Kim HY. Effects of socioeconomic level on dental scaling experience in the community: a multilevel analysis. J Korean Acad Oral Health 2016;40(2):118-125.
23. Shin BM, Bae SM, Yoo SH, Shin SJ. Oral health and occupational status among korean Adults. J Korean Soc Dent Hyg 2016;16(3):225-34.
24. Kim NH, Jeon JE, Chung WG, Kim DK. Social determinants related to the regional difference of unmet dental need in Korea. J Korean Acad Oral Health 2012;36(1):62-72.
25. Lee BG, Lee JH. Awareness and satisfaction survey regarding nation health insurance dental scaling. J Korean Acad Oral Health 2016;40(1):17-23.
26. Ko MK, Lim DS, Ahn YS. Deciding factors of regular scaling checkup in metropolitan adults. J Korean Soc Dent Hyg 2013;13(6):967-76.