The impact of national health insurance coverage on pit and fissure sealing experience

Abstract

Introduction:The purpose of this study was to review the change of supplied amount of oral pit and fissure sealing (PFS) in urban and rural areas of South Korea after including PFS into the list of treatments covered by the National Health Insurance (NHI), and to check whether there is a difference in supplied amount in areas where the dental treatment accessibility is different based on the data of the Korean National Health and Nutritional Examination Survey (KNHANES). Methods: The KNHANES data year used for 'before coverage' was 2007, and that of 'after coverage' was 2012. Data analysis was done using STATA software.Results: Areas were classified as urban or rural. Reduction of out-of-pocket expenses, according to the NHI coverage PFS experience of children aged 6-14 years, increased from 28.7% before coverage to 34.9% after coverage. PFS experience of children aged 6-14 years in the urban area was increased from 29.2% before coverage to 35.6% after coverage. The increase in rural areas was from 27.2% before coverage to 31.5% after coverage. Conclusions: Although PFS supplying was increased after inclusion in NHI coverage, it is still insufficient to reduce the decayed, missing, filled teeth index effectively. To reduce inequality, supply of PFS in rural area by community oral health program should be strengthened. And also, waiving out-of-pocket money for PFS in NHI should be considered.

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

“…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).…”

Changes in Oral Health Indicators due to Implementation of the National Health Insurance Services Coverage for First Molar Dental Sealant for Children and Adolescents in South Korea

“…Prior studies have shown that high partial copayments will be particularly burdensome for low-income individuals [25]. The relationship between socioeconomic factors and sealant has weakened after the reimbursement policy, but still existed [10].…”

Did the extended coverage policy contribute to alleviating socioeconomic inequality in untreated dental caries of both children and adolescents in South Korea?

“…In May 2013, the coverage was expanded up to the second molars of children up to 18 years old. Accordingly, the proportion of children aged 6-14 years who received dental sealant increased encouragingly, from 28.7 to 34.9% [16]. A Korean study reported that after the policy implementation, dental sealant increased and untreated caries decreased, especially among lower SEP groups [17].…”