국민건강보험 치석제거 서비스 급여 적용 대상자 확대 정책의 효과 평가

Abstract

Objectives: Korea’s National Health Insurance (NHI) coverage rate for dental services is 16.0%, far lower than the 33.0% average of OECD (Organization for Economic Co-operation and development) countries. In 2013, the government implemented a policy to pay for dental scaling service for adults over the age of 20. Then in 2017, the eligibility criteria was expanded to adults aged 19 or older the eligibility age was lowered expanded to 19 or older. Methods: The study aimed to determine the effectiveness of the policy by comparing the number of times per person the dental scaling service was used before and after the implementation of the new applicants group compared to the existing application/applicants group. The analysis was conducted among patients aged 19 and 20 who visited the hospital with gingivitis and periodontal disease and who used the dental scaling service more than once per year as a preventive measure, using the customized database of the NHIC (National Health Insurance Corporation). As of July 1, 2017 when the dental scaling service was implemented by the National Health Insurance Service, the period was set as “before enforcement” (January 2016 to June 2017) and “after enforcement” (July 2017 to December 2018). To evaluate the policy effectiveness of expandingthe ages of individuals eligible for the dental scaling service, Difference-in-Differences (DiD) analysis was conducted to examine the number of times per person the service was used, changes in personal contributions, and policy effectiveness. Results: Since the National Health Insurance policy to pay for dental scaling services, both the applicants group and the sustainable application group have increased the rate of inspection of preventive dental scaling services (19.82%→30.91%, 29.68%→31.18%). As a result of determining the pure effect of the NHI’s policy of covering the dental scaling service, it was found that the the number of times the dental scaling service was used per person increased significantly in the new application group (0.03 times, <.0001). Conclusions: However, it was found that the cost of the dental scaling service per person while the cost of the dental scaling decreased was shown to decrease, it was not statistical significant. Therefore, additional policy support such as lowering the personal financial burden is needed for those who are unable to afford the service.