Unmet Dental Care Needs among Korean National Health Insurance Beneficiaries Based on Income Inequalities: Results from Five Waves of a Population-Based Panel Study

Abstract

This study investigates whether self-employed beneficiaries experience greater difficulties in accessing dental care than insured employees based on their income level. This analysis uses 2011–2015 data from the Korea Health Panel, a population-based and nationally representative sample, covering 7083 participants aged 18 years and older. We measured barriers to dental access based on unmet needs or the inability to receive necessary dental care owing to the past year’s economic burdens. The type of health insurance and household income are considered independent variables. We applied multiple panel logistic regressions and two-panel logistic regression models with a fixed-effects approach to analyze the data. Self-employed beneficiaries were 1.16 times (95% confidence interval (CI) = 1.08–1.24) more likely to experience unmet dental needs than were insured employees. Insured employees and self-employed beneficiaries belonging to the lowest income bracket were 1.76 times (95% CI = 1.53–2.03) and 2.33 times (95% CI = 1.89–2.87) more likely to have unmet needs than those in the highest income bracket. Self-employed beneficiaries were 1.31 times (95% CI = 1.21–1.43) more likely to experience unmet dental needs caused by economic burdens than are insured employees. Insured employees of the lowest income quintile were 4.15 times (95% CI = 3.41–5.05) more likely to experience unmet needs caused by economic burdens, while the odds ratio for self-employed beneficiaries was 5.47 (95% CI = 4.05–7.39). Our findings indicate gaps in unmet dental needs between self-employed beneficiaries and insured employees. The government should adopt strategies to reduce unmet needs among marginalized groups and redefine the role of national health insurance.

Unmet dental care needs of homeless adults in South Korea: Findings from a national survey

“…However, homeless and low-income groups have reported a higher rate of unmet dental care needs in other South Korean studies (Sohn et al, 2020). Although national health insurance and MA cover essential services, the rate of out-of-pocket payment for dental care TA B L E 2 Association between unmet dental care needs and respondents' characteristics services is still 81.9% in South Korea (Sohn et al, 2020).…”

Impact of Long Working Hours and Shift Work on Perceived Unmet Dental Need: A Panel Study

“…However, household income level also showed a significant association with total perceived unmet dental needs (including financial reasons and time scarcity)—but only in women. Income is a well-established predisposing factor for unmet dental needs according to previous Korean studies [ 2 , 9 , 10 ] and many studies reported that women reported more perceived unmet dental needs than men [ 7 , 9 , 10 ]. However, the evidence on gender differences in the association between income and unmet dental care has been inconsistent.…”

“…The enabling domain includes personal/family resources, while the need domain includes perceived and evaluated need [ 6 ]. Previous Korean studies have found a correlation between perceived unmet dental care needs and (1) predisposing variables such as younger age, female gender, marital status, and low education level [ 2 , 7 ]; (2) enabling variables such as income, engagement in precarious work, unemployment, medical aid as a type of insurance, and long working hours [ 2 , 8 , 9 , 10 , 11 ], and (3) need factors such as poor oral health status [ 12 ].…”

“…The majority of previous Korean studies on unmet dental needs have focused on socioeconomic inequalities rather than time-related factors [ 2 , 8 , 9 , 10 ]. However, socially deprived people and time poor do not always coincide.…”

Unmet Healthcare Needs, Catastrophic Health Expenditure, and Health in South Korea’s Universal Healthcare System: Progression Towards Improving Equity by NHI Type and Income Level

“…Of note, MA beneficiaries persistently experienced unmet healthcare needs, despite a lower risk of catastrophic health expenditure relative to other groups, because they did not have to make deductible payments, which forced them to limit medical services availed because of the deduction ceiling. It has also been confirmed that the lowest income and self-deployed benefits are more likely to experience unmet dental needs in the dental field of Korea [ 28 ]. Recently, Moon Care allowed for increased insurance coverage aimed to mitigate catastrophic health expenditure and unmet healthcare needs.…”