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韩国牙科健康保险政策对老年人的社会经济影响:韩国一项全国性队列研究

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea.

作者信息

Seo Hyewon, Lee Bo-Ah, Lim Hyunsun, Yoon Joon-Ho, Kim Young-Taek

机构信息

Departement of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

出版信息

J Periodontal Implant Sci. 2019 Jul 31;49(4):248-257. doi: 10.5051/jpis.2019.49.4.248. eCollection 2019 Aug.

Abstract

PURPOSE

The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies.

METHODS

Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups.

RESULTS

Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group.

CONCLUSIONS

Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

摘要

目的

本回顾性研究旨在调查韩国牙科保险覆盖类型与社会人口学特征、全身疾病和口腔疾病患病率之间的关系,并评估韩国牙科保险政策的社会经济影响。

方法

从国民健康保险服务中心获取2006年至2015年的样本队列数据。患者分为两组。暴露组包括接受全口义齿、可摘局部义齿和种植治疗保险福利的患者,而对照组包括未接受这些福利的患者。比较两组之间的保险覆盖类型以及全身疾病和口腔疾病的患病率。

结果

接受全口义齿、可摘局部义齿和种植体形式福利的患者在性别、年龄、收入五分位数和保险覆盖类型方面的社会人口学特征与对照组相似。暴露组中高血压、贫血、肾病、类风湿性关节炎、骨质疏松症、哮喘和脑梗死的患病率高于对照组(<0.05)。暴露组中牙周疾病和龋齿的患病率也更高。

结论

韩国牙科健康保险政策对因全身疾病而承受费用负担的低收入和老年人的医疗费用有益。然而,由于老年患者因全身疾病风险高而倾向于避免侵入性干预,从社会经济角度来看,义齿保险覆盖可能比种植牙治疗保险覆盖更有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a6b/6713804/9de82e7cba94/jpis-49-248-g001.jpg

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