Influence of dental insurance coverage on access to preventive periodontal care in middle-aged and elderly populations: analysis of representative Korean Community Health Survey Data (2011–2015)

Abstract

Objectives This study aimed to explore the influence of dental insurance coverage on access to preventive periodontal care. Data were extracted from the 2011, 2013 and 2015 Korean Community Health Surveys conducted by the Korea Centers for Disease Control and Prevention. Materials and methods This study was designed as a 5‐year time series analysis using secondary data. Trends in the utilisation rate of dental scaling services before and after the introduction of insurance coverage for dental scaling were evaluated, and the influence of dental insurance coverage on access to preventive periodontal care was assessed. Results In the 4 years after 2011, the utilisation rate of scaling services increased by 12.3%. The increase in the utilisation rate from 2011 to 2015 was greater for participants ≥ 65 years old and 45–64 years old compared with those who were 19–34 or 35–44 years old. The odds ratios (ORs) for using scaling in 2011, 2013 and 2015 were 0.9, 1.1 and 1.5, respectively, for participants with healthy gingiva. For elderly participants with gingival bleeding, the utilisation rate of scaling services increased after 2015 with ORs of 0.8, 0.9 and 1.2 for 2011, 2013 and 2015, respectively. Conclusions Insurance coverage for dental scaling positively influenced access to preventive care for periodontal disease in middle‐aged and elderly individuals. In the future, the long‐term contributions of dental insurance coverage to the prevalence of periodontal disease and oral health disparities should be evaluated.

An Investigation of the Association between Health Screening and Dental Scaling in Korea

“…Similar results have been reported in other studies of the rate of dental scaling [23,72,73]. Even after dental insurance with a coverage extension that induced a change in utilization, the absolute rate decreased with age [21,74]. A study from England showed that health check attendees decreased with age in both the underserved and general populations [75].…”

“…After the policy, the number of people using dental scaling increased [21], and the number of people with healthy periodontal conditions increased as well [22]. However, there were socioeconomic inequalities [23], and some argued that it became severe after the policy that included dental scaling in the NHI [24].…”

Did the Expansion of Insurance Coverage for Oral Health Reduce Self-reported Oral Health Inequalities in Korea? Results of Repeated Cross-Sectional Analysis, 2007–2015

“…5 We verified that dental service utilization increased as a result of reduced OOP expenses. 7,25,30 Whether these results are linked to oral health inequalities requires confirmation over a longer period of time.…”

“…[2][3][4] Further work is required to verify whether dental health insurance affects inequalities in oral health beyond access to dental care. Studies conducted in the aftermath of the insurance expansion confirmed that access to dental service was improved [5][6][7] ; however, disparities in access to services remained. 6,8,9 Currently, few studies have evaluated whether the dental health insurance expansion improved oral health inequalities (not just service access).…”

Did expanded access to denture services improve chewing ability in the Korean older population? Results of a regression discontinuity analysis

“…Cost reduction is also one of the main foci of dental insurance studies 7 , 8 , 15 , 16 . For example, within the Korean context, after the expansion of dental insurance, the accessibility of dental care improved 10 , 11 , 14 . However, there have been inconsistent findings on the impact for oral health disparities, with some reports indicating a reduction 12 , while others reporting widening inequalities 9 , 13 , 14 .…”