Background People with disabilities face difficulties in oral health management and gaining acces... more Background People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities. Methods Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002–2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated. Results The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among ol...
Background This study aimed to investigate the effects of orthodontic treatment on cumulative out... more Background This study aimed to investigate the effects of orthodontic treatment on cumulative out-of-pocket (OOP) expenditures for up to 8 years and the factors contributing to changes in individual OOP dental expenses. Methods The data of adults aged ≥19 years, 218 with experience of orthodontic treatment (OT group) and 654 without experience of orthodontic treatment (non-OT group) were extracted from the Korea Health Panel Survey between 2009 and 2017 using the propensity score matching method. The total personal OOP expenditure for dental care incurred after orthodontic treatment in the OT group and that incurred in the matched non-OT group were calculated. Since dependent variables, cumulative dental expenditures, were continuous with excess zeros, Tweedie compound Poisson linear models were used to explore the influence of orthodontic treatment experience and demographic and socioeconomic factors, including private insurance, on per capita OOP dental expenditures. Results The O...
OBJECTIVES: Population aging is rapidly accelerating worldwide. Oral diseases related to aging ar... more OBJECTIVES: Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS).METHODS: Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models.RESULTS: Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population...
International Journal of Environmental Research and Public Health, 2022
This study analyzed patient preferences using travel time from residence to dental institution wh... more This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health Panel from 2008 to 2017 and analyzed each dental service episode. Since the distribution of travel time was skewed to the left, median travel time was analyzed. The association of travel time with services was analyzed via the population-averaged generalized estimating equation (GEE) with the Poisson family. The median of the average travel time per episode was longer for non-National Health Insurance (NHI)-covered services and shorter for NHI-covered services. The first quintile of low-income subjects traveled the longest for all services and utilized dental care the most. In the GEE analysis, travel time was approximately three times longer for implant treatment and gold inlay/resin fillings and >2 times longer for orthodontic care than for NHI-covered services. Patients residing in rural counties traveled for lo...
Asian American and Pacific Islander journal of health, 2000
OBJECTIVE: To examine patterns and factors associated with the utilization of health care service... more OBJECTIVE: To examine patterns and factors associated with the utilization of health care services among Korean American elderly (KAE). DATA SOURCES/STUDY SETTING: Data collected from a survey of facetoface interviews with 205 KAE, aged 60 years and older, residing in the Greater Baltimore Metropolitan area in 1999. STUDY DESIGN: We employed a cross-sectional design, based on the behavioral model of health service utilization for vulnerable populations. Poisson regression was used to estimate parameters associated with physician visits, the utilization of Oriental medicine, and hospitalization. DATA COLLECTION: Data were collected using face-to-face interviews with 205 KAE. PRINCIPAL FINDINGS: About 60% of respondents reported that they could not get care when needed, and the majority (86%) had experienced difficulty getting care. About 71% of respondents visited a physician, and 25% used Oriental medicine at least once during the previous 6 months. Only 8% visited an emergency ro...
Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of polici... more Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the rati...
Background People with disabilities face difficulties in oral health management and gaining acces... more Background People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities. Methods Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002–2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated. Results The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among ol...
Background This study aimed to investigate the effects of orthodontic treatment on cumulative out... more Background This study aimed to investigate the effects of orthodontic treatment on cumulative out-of-pocket (OOP) expenditures for up to 8 years and the factors contributing to changes in individual OOP dental expenses. Methods The data of adults aged ≥19 years, 218 with experience of orthodontic treatment (OT group) and 654 without experience of orthodontic treatment (non-OT group) were extracted from the Korea Health Panel Survey between 2009 and 2017 using the propensity score matching method. The total personal OOP expenditure for dental care incurred after orthodontic treatment in the OT group and that incurred in the matched non-OT group were calculated. Since dependent variables, cumulative dental expenditures, were continuous with excess zeros, Tweedie compound Poisson linear models were used to explore the influence of orthodontic treatment experience and demographic and socioeconomic factors, including private insurance, on per capita OOP dental expenditures. Results The O...
OBJECTIVES: Population aging is rapidly accelerating worldwide. Oral diseases related to aging ar... more OBJECTIVES: Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS).METHODS: Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models.RESULTS: Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population...
International Journal of Environmental Research and Public Health, 2022
This study analyzed patient preferences using travel time from residence to dental institution wh... more This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health Panel from 2008 to 2017 and analyzed each dental service episode. Since the distribution of travel time was skewed to the left, median travel time was analyzed. The association of travel time with services was analyzed via the population-averaged generalized estimating equation (GEE) with the Poisson family. The median of the average travel time per episode was longer for non-National Health Insurance (NHI)-covered services and shorter for NHI-covered services. The first quintile of low-income subjects traveled the longest for all services and utilized dental care the most. In the GEE analysis, travel time was approximately three times longer for implant treatment and gold inlay/resin fillings and >2 times longer for orthodontic care than for NHI-covered services. Patients residing in rural counties traveled for lo...
Asian American and Pacific Islander journal of health, 2000
OBJECTIVE: To examine patterns and factors associated with the utilization of health care service... more OBJECTIVE: To examine patterns and factors associated with the utilization of health care services among Korean American elderly (KAE). DATA SOURCES/STUDY SETTING: Data collected from a survey of facetoface interviews with 205 KAE, aged 60 years and older, residing in the Greater Baltimore Metropolitan area in 1999. STUDY DESIGN: We employed a cross-sectional design, based on the behavioral model of health service utilization for vulnerable populations. Poisson regression was used to estimate parameters associated with physician visits, the utilization of Oriental medicine, and hospitalization. DATA COLLECTION: Data were collected using face-to-face interviews with 205 KAE. PRINCIPAL FINDINGS: About 60% of respondents reported that they could not get care when needed, and the majority (86%) had experienced difficulty getting care. About 71% of respondents visited a physician, and 25% used Oriental medicine at least once during the previous 6 months. Only 8% visited an emergency ro...
Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of polici... more Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the rati...
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Papers by Hosung Shin