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Lee and Oh: Perceptions and behaviors of dental practitioners with regard to the National Health Insurance
Original Article

J Korean Acad Oral Health 2014;38(4):246-253.

Published online: 12 December 2014

DOI: https://doi.org/10.11149/jkaoh.2014.38.4.246

Perceptions and behaviors of dental practitioners with regard to the National Health Insurance

Sun-Ho Lee1, Hyo-Won Oh1, 2

1Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, Iksan, Korea

2Institute of Biomaterials·Implant and Institute of Wonkwang Dental Research, Wonkwang University, Iksan, Korea

Corresponding Author: Hyo-Won Oh Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, #460, Iksandae-ro, Iksan 570-749, Korea Tel: +82-63-850-6851 Fax: +82-63-850-7313 E-mail: dhdh@wonkwang.ac.kr

Received 18 November 2014       Revised 17 December 2014       Accepted 29 December 2014

Copyright © 2014 Journal of Korean Academy of Oral Health

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The present study aimed to examine the perceptions and behaviors of dentists regarding the National Dental Health Insurance, and their opinions for improving its policies.

Methods

A self-report survey was conducted with 1,321 dentists selected from the Alumni Association of the W University College of Dentistry. We finally recovered and analyzed 243 questionnaires, excluding those returned with insincere answers.

Results

Only 40.3% of the practitioners recorded the disease name, 12.8% of medical records were unrecorded, and 54.5% of the respondents did not receive the expenses borne by the principal. In addition, 14.0% of the practitioners had administrative dispositions or had been penalized with surcharge, and 74.6% of the respondents stated that dental care benefits should be expanded. Further, 92.2% of the respondents agreed that a course on dental health insurance should be offered at the university. Additionally, 80.6% of the participants stated that they were willing to participate in supplementary training programs that emphasize on dental health insurance. If supplementary training programs were to take place, 46.0% of the participants reported that they preferred courses that focused on dental health insurance in general, and 22.2% reported that they should focus on the decrease in health insurance. Finally, participants reported that insurance claims for each department had reduced for periodontal treatment (70.7%), other treatments (15.7%), and endodontic treatment (9.6%).

Conclusions

It is necessary for dental practitioners to be educated on the National Health Insurance, in general, as well as on insurance claims.

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Keywords: Behaviors, Dentist, Health insurance, Perception

References

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Table 1.
The general characteristics of respondents
Characteristics Classification N (%)
Gender Male 229 (94.2)
Female 14 (5.8)
Total 243 (100)
Age (yrs) 30-39 59 (24.3)
40-49 157 (64.6)
>50 27 (11.1)
Total 243 (100)
Education level DDS 115 (47.5)
MSD/PhD 127 (52.5)
Total 242 (100)
License holding period (yrs) ≤10 37 (15.8)
11-20 130 (55.6)
≥21 67 (28.6)
Total 234 (100)
Graduate in dental residency program Yes 44 (18.3)
No 196 (81.7)
Total 240 (100)
Job tenure (yrs) ≤10 130 (54.2)
≥11 110 (45.8)
Total 240 (100)
Type of hospital Private 215 (88.5)
Co-run 28 (11.5)
Total 243 (100)
Hospital location Urban 190 (88.0)
Non-urban 26 (12.0)
Total 216 (100)
Table 2.
Perceptions and behaviors of respondents regards to National Health insurance N (%)
Variables Positive Negative Total Mean±SD
Strongly agree Agree Disagree Strongly disagree
Making recording of medical records 72 (29.6) 140 (57.6) 27 (11.1) 4 (1.6) 243 (100) 3.15±0.67
Making recording of disease name 22 (9.1) 76 (31.3) 87 (35.8) 58 (23.9) 243 (100) 2.26±0.92
Not receiving cost-sharing by patient 5 (2.1) 127 (52.5) 45 (18.6) 65 (26.9) 242 (100) 2.30±0.89
Differing the reimbursement based on the quality of treatment 85 (35.0) 125 (51.4) 30 (12.3) 3 (1.2) 243 (100) 3.20±0.70
Administrative dispositions or penalty surcharge 34 (14.0) 209 (86.0) 243 (100) 1.14±0.35
Extent of medical care benefits of dental treatment 4 (1.7) 57 (23.8) 139 (57.9) 40 (16.7) 240 (100) 2.10±0.68
Approval of insurance course at the university 66 (27.3) 157 (64.9) 18 (7.4) 1 (0.4) 242 (100) 3.19±0.57
Willingness to participate in supplementary training 33 (13.6) 162 (66.9) 45 (18.6) 2 (0.8) 242 (100) 2.93±0.59
Table 3.
Perceptions of respondents about dental treatments with most reduced claim and the preferable lecture contents in supplementary training programs
Items N (%)
Mainly reduced dental treatments for insurance claim
Periodontal treatment 162 (70.7)
Endodontic treatment 22 (9.6)
Filling treatment 3 (1.3)
Extration treatment 6 (2.6)
Others 36 (15.7)
Total 229 (100)
The preferable lecture contents in supplementary training programs
Insurance claim 34 (14.2)
Insurance claim evaluation adjustment 53 (22.2)
Insurance claim related periodontal treatment 25 (10.5)
Overall dental health insurance 110 (46.0)
Others 17 (7.1)
Total 239 (100)
Table 4.
Perception and behaviors of National Health insurance according to socio-demographic characteristics
Characteristics Making recording of medical records Making recording of disease name Not receiving cost-sharing by patient Differing the reimbursement based on the quality of treatment Extent of medical care benefits of dental treatment Approval of insurance course at the university Willingness to participate in supplementary training
Gender
Male 3.16±0.66 2.27±0.93 2.32±0.89 3.20±0.70 2.10±0.69 3.18±0.58 2.94±0.59
Female 3.07±0.83 2.07±0.73 2.00±0.88 3.21±0.70 2.14±0.53 3.29±0.47 2.86±0.66
Total 3.15±0.67 2.26±0.92 2.30±0.89 3.20±0.70 2.10±0.68 3.19±0.57 2.93±0.59
Education level
D.D.S 3.19±0.67 2.10±0.96 2.34±0.92 3.12±0.69 2.12±0.64 3.18±0.54 2.91±0.63
MSD/PhD 3.11±0.67 2.39±0.85 2.27±0.86 3.28±0.70 2.09±0.72 3.20±0.61 2.96±0.56
Total 3.15±0.67 2.25±0.92 2.30±0.89 3.20±0.70 2.10±0.68 3.19±0.57 2.94±0.59
Graduate in dental residency program
Yes 3.16±0.68 2.16±0.91 2.32±0.93 3.14±0.77 2.00±0.75 3.30±0.67 3.05±0.58
No 3.15±0.67 2.27±0.92 2.28±0.88 3.20±0.68 2.12±0.67 3.16±0.55 2.90±0.59
Total 3.15±0.67 2.25±0.92 2.29±0.89 3.19±0.69 2.10±0.68 3.18±0.57 2.93±0.59
Type of hospital
Private 3.16±0.67 2.25±0.92 2.31±0.89 3.17±0.70 2.10±0.66 3.17±0.58 2.92±0.60
Co-run 3.07±0.66 2.32±0.94 2.22±0.93 3.43±0.63 2.14±0.80 3.36±0.49 3.04±0.51
Total 3.15±0.67 2.26±0.92 2.30±0.89 3.20±0.70 2.10±0.68 3.19±0.57 2.93±0.59
Hospital
Urban 3.16±0.67 2.25±0.93 2.34±0.87* 3.18±0.72 2.10±0.69 3.18±0.58 2.92±0.58
Non-urban 3.04±0.72 2.08±0.89 1.96±0.92 3.23±0.65 2.08±0.70 3.19±0.57 2.92±0.56
Total 3.15±0.67 2.23±0.92 2.30±0.88 3.19±0.71 2.09±0.69 3.18±0.58 2.92±0.58

*Mann-Whitney Test.

Table 5.
Correlation analysis between National Health insurance, socio-demographic characteristics and relative dental items
Variables Making recording of medical records Making ecording of disease name Not receiving cost-sharing by patient Differing the reimbursement based on the quality of treatment Extent of medical care benefits of dental treatment Approval of insurance course at the university Willingness to participate in supplementary training
Busyness index of dentist .024 ―.023 .121 ―.035 .044 ―.009 ―.075
Age (yrs) ―.089 ―.168* ―.042 .036 ―.072 .115 .080
License holding period (yrs) ―.085 ―.170** .033 ―.046 ―.082 .094 .035
Job tenure (yrs) ―.010 ―.170* ―.050 .087 ―.005 .116 .043
No. of dentists .001 ―.133* .009 ―.150* .041 ―.027 ―.043
No. of dental hygienist .002 ―.061 .139* ―.054 .081 ―.064 ―.038
No. of nurse assistant .072 ―.079 ―.053 .021 .031 .047 ―.008
No. of etc. ―.040 ―.158* .039 ―.168** .037 ―.054 .038
Perceptions of staffing adequacy .006 ―.084 .032 ―.022 ―.059 ―.011 .073
Daily maximum patient .067 ―.124 .032 ―.022 .020 .023 ―.007
Daily mimimum patient .055 ―.148* .036 ―.100 .048 .010 ―.004
Daily average patient .016 ―.115 .024 ―.109 .089 ―.009 ―.017
Number variation in patients .065 .118 ―.111 .127 ―.035 .033 .061
Competition of dental clinic ―.020 .009 .038 ―.002 .012 ―.057 .005
Revenue of dental clinic .033 .145* ―.101 .094 ―.009 .010 .082

Correlation coefficient of Spearman: *P<0.05, **P<0.01.

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