Unmet dental care needs in South Korea: how do they differ by insurance system?

Abstract

Objectives This study aimed to analyse and compare the influence of National Health Insurance and Medical Aid coverage on the persistency of unmet dental care needs in South Korea. Methods This study was based on a longitudinal sample of 4461 adults aged 19 years and older who participated in the South Korea Health Panel from 2011 to 2014, using weights to make the data nationally representative. Propensity score matching was used to adjust the demographic, socioeconomic and health status information of National Health Insurance and Medical Aid groups. Panel logistic regression analyses were conducted to examine the association between health insurance type and unmet dental needs for three consecutive years. Results The odds of the lowest income group reporting unmet dental care needs compared with the highest income group was 6.75 (confidence interval 5.94−7.67), which reduced to 4.19 (confidence interval 3.76−4.67) in the models including health insurance schemes. Additionally, Medical Aid recipients (odds ratio 2.49; 95% confidence interval 2.18−2.48) were more likely to have unmet needs than those covered by National Health Insurance. Conclusions The dental care needs of Medical Aid beneficiaries were not being met, unlike those of the National Health Insurance beneficiaries. Such evidence suggests that increasing health insurance coverage to include several essential dental services would improve the accessibility of dental care services for Medical Aid beneficiaries.

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

“…These findings move beyond previous research showing that income level is inversely associated with forgoing dental care for disadvantaged populations by documenting the importance of income inequalities in dental care service across the two beneficiary types in South Korea [11,12,15]. In concordance with the findings of a previous study of NHI and Medical Aid beneficiaries in South Korea [33], our study highlights the vulnerability of insurance beneficiaries.…”

“…In other words, a considerable proportion of the insured low-income population is at risk of forgoing dental care under South Korea's dental care system. Thus, it is necessary for health insurance schemes to ensure equality in access to dental care and to tackle the issue of high out-of-pocket costs incurred by the socially disadvantaged [33]. Increasing the scope of insurance coverage for certain dental services may eliminate economic barriers and improve access for low-income families and/or the working poor.…”

Estimating Lifetime Dental Care Expenditure in South Korea: An Abridged Life Table Approach

“…The introduction of Korea's national dental policies (to cover dental services), which were based on a private fee-for-service plan, was expected to contribute significantly to the increasing dental service utilization. For example, the Korean government implemented an initiative to achieve universal healthcare coverage including the dental sealant for children and adolescents (since 2009) as well as the cost of dental scaling in 2013, resulting in higher cost-sharing (70-90%) and lower out-of-pocket expenses (30-10%), a move to improve the level of oral health [33,34]. These progressive policies positively improved accessibility by eliminating barriers to access to dental care, namely, increased total outpatient cost for dental services in recent years [35,36].…”

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

“…The Homeless MA program was founded in 2012 to support homeless people who cannot access regular Medicaid services. MA provides homeless people with medical benefits and almost free outpatient services for dental care (approximately $1–2) with public financing (Choi, 2019); however, individuals including homeless people pay for many dental procedures (preventive care, orthodontics and restorative treatment), resulting in significantly high out‐of‐pocket expenses, amounting to 80% of total dental care costs (Che et al., 2019). This is why people do not visit dentists or follows the recommended treatment.…”