J Periodontal Implant Sci.  2018 Feb;48(1):3-11. 10.5051/jpis.2018.48.1.3.

Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study

• Park HJ
• Lee JH
• Park S
• Kim TI

• KMID: 2405405
• DOI: http://doi.org/10.5051/jpis.2018.48.1.3

Abstract

PURPOSE
This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services.
METHODS
A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs.
RESULTS
After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable.
CONCLUSIONS
The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

Keyword

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

MeSH Terms

Delivery of Health Care*
Dental Care
Dental Scaling
Diagnosis
Gingivitis
Health Care Costs
Health Policy
Health Services Accessibility
Humans
Insurance
Insurance Benefits
Korea*
National Health Programs
Outpatients*
Periodontal Diseases
Periodontitis

Figure

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  Figure 1 Trends in the total average dental cost per month over the period of the study (July 2010 through November 2015). The dashed line indicates the implementation of the new health policy.

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  Figure 2 Trends in the average dental costs per month by patient diagnosis, including advanced periodontitis patients who received scaling and gingivitis patients who received scaling, over the period of the study (July 2010 through November 2015). The dashed line indicates the implementation of the new health policy.

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