Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database
Abstract
:1. Introduction
2. Material and Methods
2.1. Data Resource
2.2. Study Variables
2.3. Statistical Analysis
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Ministry of Health and Welfare (MOHW). Policies for the Elderly. Available online: http://www.mohw.go.kr/front_new/policy/index.jsp?PAR_MENU_ID=06&MENU_ID=063901 (accessed on 15 January 2021).
- McGowan, M.M.; Healey, B.J.; Evans, T. Cost-effectiveness analysis: Extending dental care coverage to medicare beneficiaries. Journal of Economics and Economic Education Research. 2016, 17, 193. [Google Scholar]
- Richmond, S.; Chestnutt, I.; Shennan, J.; Brown, R. The relationship of medical and dental factors to perceived general and dental health. Commun. Dent. Oral Epidemiol. 2007, 35, 89–97. [Google Scholar] [CrossRef]
- Gilbert, G.H.; Foerster, U.; Duncan, R.P. Satisfaction with chewing ability in a diverse sample of dentate adults. J. Oral Rehabil. 1998, 25, 15–27. [Google Scholar] [CrossRef]
- National Health Insurance Service(NHIS). The national health insurance coverage of denture for the elderly. Available online: http://minwon.nhis.or.kr/menu/retriveMenuSet.xx?menuId=MENU_WBMAC0218 (accessed on 10 January 2021).
- National Health Insurance Service(NHIS). Cost-Effectiveness Analysis of the National Health Insurance Coverage of Denture and Implants for the Elderly; National Health Insurance Service (NHIS): Wonju, Korea, 2016. [Google Scholar]
- Kang, Y.W.; Ko, Y.S.; Kim, Y.J.; Sung, K.M.; Kim, H.J.; Choi, H.Y.; Sung, C.; Jeong, E. Korea community health survey data profiles. Osong Public Health Res. Perspecti. 2015, 6, 211–217. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kim, S.J.; Han, J.A.; Kim, Y.H.; Choi, B.Y.; Kim, S.Y.; Lee, H.J.; Oh, I.H.; Cho, S.-I.; Lee, J.; Lee, S.Y. Test-retest reliability of health behavior items in the community health survey in south korea. Epidemiol. Health 2015, 37. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dimick, J.B.; Ryan, A.M. Methods for evaluating changes in health care policy: The difference-in-differences approach. Jama 2014, 312, 2401–2402. [Google Scholar] [CrossRef]
- Lee, M.-j.; Kang, C. Identification for difference in differences with cross-section and panel data. Econ. Lett. 2006, 92, 270–276. [Google Scholar] [CrossRef]
- Choi, Y.; Kim, J.-H.; Yoo, K.-B.; Cho, K.H.; Choi, J.-W.; Lee, T.H.; Kim, W.; Park, E.-C. The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: A study of the korean health panel survey (2008–2012). BMC Health Serv. Res. 2015, 15, 1. [Google Scholar] [CrossRef] [Green Version]
- Ahn, E.; Kim, M.Y.; Shin, H. Horizontal inequities in dental service utilization. J. Korean Acad. Oral Health 2015, 39, 9–16. [Google Scholar] [CrossRef] [Green Version]
- Somkotra, T. Experience of socioeconomic-related inequality in dental care utilization among thai elderly under universal coverage. Geriatr. Gerontol. Int. 2013, 13, 298–306. [Google Scholar] [CrossRef]
- Quiñonez, C.; Grootendorst, P. Equity in dental care among canadian households. Int. J. Equity Health 2011, 10, 1. [Google Scholar] [CrossRef] [Green Version]
- Kim, H.-s.; Ahn, E.; Kim, M.-Y.; Kim, S.-M.; Shin, H. Trends of household income and dental care spending. J. Korean Acad. Oral Health 2014, 38, 17–24. [Google Scholar] [CrossRef] [Green Version]
- Yeo, J.; Jung, H. Determinants of dental screening and unmet dental needs: Interaction effect between geographical accessibility and economic affordability. Korean J. Health Econ. Policy 2012, 18, 109–126. [Google Scholar]
- Organization for Economic Cooperation and Development (OECD). Pensions at a Glance; OECD Publishing: Paris, France, 2015. [Google Scholar]
- Ministry of Health and Welfare (MOHW). Research Study on Then Status of the Elderly; Ministry of Health and Welfare (MOHW): Osong, Korea, 2014.
- Hyun, K.R.; Kang, S.; Lee, S. Population aging and healthcare expenditure in korea. Health Econ. 2015, 25, 1239–1251. [Google Scholar] [CrossRef] [PubMed]
- Kelley, A.S.; McGarry, K.; Fahle, S.; Marshall, S.M.; Du, Q.; Skinner, J.S. Out-of-pocket spending in the last five years of life. J. Gen. Intern. Med. 2013, 28, 304–309. [Google Scholar] [CrossRef] [Green Version]
- Park, E.-J.; Kwon, J.-W.; Lee, E.-K.; Jung, Y.-H.; Park, S. Out-of-pocket medication expenditure burden of elderly koreans with chronic conditions. Int. J. Gerontol. 2015, 9, 166–171. [Google Scholar] [CrossRef] [Green Version]
- Statistics Korea. The Aged Statistics. Available online: http://kostat.go.kr/portal/korea/index.action (accessed on 13 January 2021).
- Griffin, S.O.; Jones, J.A.; Brunson, D.; Griffin, P.M.; Bailey, W.D. Burden of oral disease among older adults and implications for public health priorities. Am. J. Public Health 2012, 102, 411–418. [Google Scholar] [CrossRef] [PubMed]
- Ministry of Health and Welfare (MOHW); Korea Human Resource Development Institute for Health and Welfare. 2016 Community Integrated Health Promotion Program. Presentation; Ministry of Health and Welfare (MOHW): Osong, Korea, 2016.
- Moeller, J.F.; Chen, H.; Manski, R.J. Investing in preventive dental care for the medicare population: A preliminary analysis. Am. J. Public Health 2010, 100, 2262–2269. [Google Scholar] [CrossRef]
- Marshall, S.E.; Cheng, B.; Northridge, M.E.; Kunzel, C.; Huang, C.; Lamster, I.B. Integrating oral and general health screening at senior centers for minority elders. Am. J. Public Health 2013, 103, 1022–1025. [Google Scholar] [CrossRef]
- Kowash, M.; Toumba, K.; Curzon, M. Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries. Eur. Arch. Paediatr. Dent. 2006, 7, 130–135. [Google Scholar] [CrossRef] [PubMed]
- Levin, L.; Shenkman, A. The relationship between dental caries status and oral health attitudes and behavior in young israeli adults. J. Dent. Educ. 2004, 68, 1185–1191. [Google Scholar] [CrossRef]
- Choi, J.H.; Cho, H.J.; Bae, K.H.; Jin, B.H.; Paik, D.I. Expert’s opinions on the national oral health examination evaluation system. J. Korean Acad. Oral Health 2012, 36, 153–160. [Google Scholar]
- Oh, S.-H.; Lee, Y.-J.; Lee, Y.-J.; Lee, J.-M.; Lee, J.-H.; Kim, S.-H. A study on the recognition about national health insurance coverage of denture, implant of elderly people. J. Dent. Hyg. Sci. 2014, 14, 502–509. [Google Scholar] [CrossRef] [Green Version]
- Lee, O.H.; Seo, N.G.; Choi, D.S.; Kang, T.W.; Yoo, J.H.; Lee, H.J.; Lee, J.S. Report on Out-of-Pocket Expenditure in Nhi in 2013; Health Insurance Policy Institute in National Health Insurance Service: Seoul, Korea, 2014. [Google Scholar]
- Koo, S.; Cho, J.; Ahn, E.; Cho, S.; Park, H.Y. Use of health information among older adults: Trust and source of health information by gender and region. Health Social Welf. Rev. 2016, 36, 454–479. [Google Scholar]
65–74 | ≥75 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total | Having Denture | Not Having Denture | p | Total | Having Denture | Not Having Denture | p | ||||||
N | % | N | % | N | % | N | % | ||||||
Before coverage (2011) | |||||||||||||
Total | 4997 | 2319 | 46.4% | 2678 | 53.6% | 3507 | 1381 | 39.4% | 2126 | 60.6% | |||
Missing teeth | Yes | 1530 | 1091 | 71.3% | 439 | 28.7% | <0.0001 | 1607 | 830 | 51.6% | 777 | 48.4% | <0.0001 |
No | 3467 | 1228 | 35.4% | 2239 | 64.6% | 1900 | 551 | 29.0% | 1349 | 71.0% | |||
Perceived oral health status | Good | 96 | 51 | 53.1% | 45 | 46.9% | 0.0002 | 52 | 21 | 40.4% | 31 | 59.6% | <0.0001 |
Not bad | 519 | 282 | 54.3% | 237 | 45.7% | 296 | 152 | 51.4% | 144 | 48.6% | |||
Bad | 4382 | 1986 | 45.3% | 2396 | 54.7% | 3159 | 1208 | 38.2% | 1951 | 61.8% | |||
Oral health examination | Yes | 722 | 381 | 52.8% | 341 | 47.2% | <0.0001 | 284 | 143 | 50.4% | 141 | 49.6% | <0.0001 |
No | 4275 | 1938 | 45.3% | 2337 | 54.7% | 3223 | 1238 | 38.4% | 1985 | 61.6% | |||
Periodontal disease | Yes | 2688 | 1121 | 41.7% | 1567 | 58.3% | <0.0001 | 1935 | 694 | 35.9% | 1241 | 64.1% | <0.0001 |
No | 2274 | 1181 | 51.9% | 1093 | 48.1% | 1486 | 664 | 44.7% | 822 | 55.3% | |||
N/A | 35 | 17 | 48.6% | 18 | 51.4% | 86 | 23 | 26.7% | 63 | 73.3% | |||
After coverage (2013) | |||||||||||||
Total | 4875 | 2326 | 47.7% | 2549 | 52.3% | 3885 | 1683 | 43.3% | 2202 | 56.7% | |||
Missing teeth | Yes | 1433 | 1009 | 70.4% | 424 | 29.6% | <0.0001 | 1596 | 911 | 57.1% | 685 | 42.9% | <0.0001 |
No | 3442 | 1317 | 38.3% | 2125 | 61.7% | 2289 | 772 | 33.7% | 1517 | 66.3% | |||
Perceived oral health status | Good | 99 | 57 | 57.6% | 42 | 42.4% | <0.0001 | 88 | 47 | 53.4% | 41 | 46.6% | <0.0001 |
Not bad | 569 | 326 | 57.3% | 243 | 42.7% | 388 | 223 | 57.5% | 165 | 42.5% | |||
Bad | 4207 | 1943 | 46.2% | 2264 | 53.8% | 3409 | 1413 | 41.4% | 1996 | 58.6% | |||
Oral health examination | Yes | 707 | 363 | 51.3% | 344 | 48.7% | 0.0009 | 368 | 182 | 49.5% | 186 | 50.5% | <0.0001 |
No | 4168 | 1963 | 47.1% | 2205 | 52.9% | 3517 | 1501 | 42.7% | 2016 | 57.3% | |||
Periodontal disease | Yes | 2699 | 1198 | 44.4% | 1501 | 55.6% | <0.0001 | 2068 | 838 | 40.5% | 1230 | 59.5% | <0.0001 |
No | 2159 | 1123 | 52.0% | 1036 | 48.0% | 1799 | 841 | 46.7% | 958 | 53.3% | |||
N/A | 17 | 5 | 29.4% | 12 | 70.6% | 18 | 4 | 22.2% | 14 | 77.8% |
Variables | OR | 95% CI | ||
---|---|---|---|---|
Age | 65–74 | 1.000 | ||
≥75 | 0.875 | 0.859 | 0.890 | |
Year | 2011 | 1.000 | ||
2013 | 1.060 | 1.043 | 1.078 | |
Age * Year | 1.038 | 1.021 | 1.055 | |
Missing teeth | Yes | 1.969 | 1.934 | 2.004 |
No | 1.000 | |||
Perceived oral health status | Good | 1.000 | ||
Not bad | 1.251 | 1.189 | 1.317 | |
Bad | 0.727 | 0.696 | 0.760 | |
Oral health examination | Yes | 1.119 | 1.091 | 1.148 |
No | 1.000 | |||
Periodontal disease | Yes | 1.104 | 1.037 | 1.176 |
No | 1.000 | |||
N/A | 0.618 | 0.547 | 0.699 | |
Gender | M | 0.751 | 0.730 | 0.773 |
F | 1.000 | |||
Region | City | 1.165 | 1.141 | 1.190 |
Rural | 1.000 | |||
Economic activity | Yes | 1.106 | 1.085 | 1.126 |
No | 1.000 | |||
Family income | Q1 (low) | 0.932 | 0.902 | 0.964 |
Q2 | 1.024 | 0.991 | 1.058 | |
Q3 | 1.023 | 0.990 | 1.057 | |
Q4 (high) | 1.000 | |||
N/A | 0.994 | 0.940 | 1.050 | |
Health insurance coverage | Medical aid | 0.847 | 0.821 | 0.873 |
NHI | 1.000 | |||
Education | ≤Elementary | 0.723 | 0.697 | 0.750 |
≤Middle school | 1.005 | 0.959 | 1.053 | |
≤high school | 1.000 | |||
≥college | 1.282 | 1.192 | 1.380 | |
Marital status | Married | 1.283 | 1.188 | 1.385 |
Non-partnered | 1.078 | 0.999 | 1.164 | |
Never married | 1.000 | |||
Smoking | Yes | 1.034 | 1.008 | 1.061 |
No | 1.000 | |||
Drinking | Yes | 1.132 | 1.112 | 1.152 |
No | 1.000 |
Variables | OR | 95% CI | |||
---|---|---|---|---|---|
Health insurance coverage | |||||
Medical aid | Age | 65–74 | 1.000 | ||
≥75 | 0.925 | 0.871 | 0.983 | ||
Year | 2011 | 1.000 | |||
2013 | 1.069 | 1.009 | 1.133 | ||
Age * Year | 1.107 | 1.045 | 1.172 | ||
NHI | Age | 65–74 | 1.000 | ||
≥75 | 0.871 | 0.855 | 0.887 | ||
Year | 2011 | 1.000 | |||
2013 | 1.059 | 1.041 | 1.041 | ||
Age * Year | 1.033 | 1.015 | 1.051 | ||
Oral health examination | |||||
Yes | Age | 65–74 | 1.000 | ||
≥75 | 0.925 | 0.875 | 0.977 | ||
Year | 2011 | 1.000 | |||
2013 | 0.983 | 0.933 | 1.035 | ||
Age * Year | 1.048 | 0.995 | 1.104 | ||
No | Age | 65–74 | 1.000 | ||
≥75 | 0.870 | 0.854 | 0.886 | ||
Year | 2011 | 1.000 | |||
2013 | 1.069 | 1.051 | 1.088 | ||
Age * Year | 1.035 | 1.017 | 1.053 | ||
Family income | |||||
Q1 (Low) | Age | 65–74 | 1.000 | ||
≥75 | 0.932 | 0.900 | 0.964 | ||
Year | 2011 | 1.000 | |||
2013 | 1.029 | 0.996 | 1.064 | ||
Age * Year | 1.074 | 1.039 | 1.110 | ||
Q2 | Age | 65–74 | 1.000 | ||
≥75 | 0.849 | 0.819 | 0.880 | ||
Year | 2011 | 1.000 | |||
2013 | 1.084 | 1.047 | 1.123 | ||
Age * Year | 1.037 | 1.002 | 1.074 | ||
Q3 | Age | 65–74 | 1.000 | ||
≥75 | 0.854 | 0.822 | 0.888 | ||
Year | 2011 | 1.000 | |||
2013 | 1.031 | 0.995 | 1.069 | ||
Age * Year | 1.053 | 1.016 | 1.092 | ||
Q4 (High) | Age | 65–74 | 1.000 | ||
≥75 | 0.863 | 0.828 | 0.899 | ||
Year | 2011 | 1.000 | |||
2013 | 1.077 | 1.038 | 1.117 | ||
Age * Year | 1.021 | 0.984 | 1.059 | ||
N/A | Age | 65–74 | 1.000 | ||
≥75 | 0.865 | 0.801 | 0.934 | ||
Year | 2011 | 1.000 | |||
2013 | 1.165 | 1.083 | 1.253 | ||
Age * Year | 0.916 | 0.852 | 0.985 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Lee, Y.S.; Kim, J.; Choy, Y.S.; Kim, E.; Yoo, J. Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database. Int. J. Environ. Res. Public Health 2021, 18, 2283. https://doi.org/10.3390/ijerph18052283
Lee YS, Kim J, Choy YS, Kim E, Yoo J. Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database. International Journal of Environmental Research and Public Health. 2021; 18(5):2283. https://doi.org/10.3390/ijerph18052283
Chicago/Turabian StyleLee, Ye Seol, Juyeong Kim, Yoon Soo Choy, Eunkyong Kim, and Jaehyun Yoo. 2021. "Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database" International Journal of Environmental Research and Public Health 18, no. 5: 2283. https://doi.org/10.3390/ijerph18052283