The Demands and Awareness of Pediatric Dentists on the Korean National Health Insurance System

Y. Kim, Y. Chae, Koeun Lee, Misun Kim, O. Nam, Sung-Hyun Choi, Hyo-seol Lee
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Abstract

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into ‘general background of the respondents’, ‘the awareness on national health insurance (NHI) and DHI’, ‘the awareness on DHI pertaining to pediatric dentistry’, ‘issues that need improvement on DHI pertaining to pediatric dentistry’, ‘DHI claims’, and ‘the roles of KAPD in DHI’. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.
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儿童牙医对国民健康保险制度的要求和认识
本研究的目的是调查儿童牙医对牙科健康保险(DHI)系统的认识和看法。在线调查发送给韩国儿科牙科学会(KAPD)的成员,并收集反馈。该调查由41个问题组成,被细分为“受访者的一般背景”、“对国民健康保险(NHI)和DHI的认识”、“与儿童牙科有关的DHI的认识”、“与儿童牙科有关的DHI需要改进的问题”、“DHI索赔”和“KAPD在DHI中的作用”。共有302人回复,回复率为28.9%。除去2份回答不足的问卷,共分析了300份调查结果。根据分析,儿科牙医认为DHI的覆盖范围不如NHI,但希望其范围在未来扩大。复合树脂充填和牙槽充填的满意率高于荧光定量龋检。儿科牙医认为永久性牙复合树脂填充(65.7%)需要增加保险共付额,而局部氟化物应用(74.7%)需要保险覆盖。健康保险索赔一般由牙科保健员和/或护理助理处理。大约一半的受访者回答说,他们有上诉保险拒绝的经历。最后,儿科牙医普遍对为DHI提供信息持积极态度。本研究可望为儿童牙科的DHI政策发展提供健全的资料集。
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