Journal List > J Korean Acad Oral Health > v.43(3) > 1134763

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Ryu, Jung, Han, Lee, and Jeon: Financial estimate of light-curing composite resin treatment after National Health Insurance Service coverage
Original Article

J Korean Acad Oral Health 2019;43(3):136-141.

Published online: 15 September 2019

DOI: https://doi.org/10.11149/jkaoh.2019.43.3.136

Financial estimate of light-curing composite resin treatment after National Health Insurance Service coverage

Jae-In Ryu1, Se-Hwan Jung2, Dong-Hun Han3, Sae-Rom Lee1, Ji-Eun Jeon4,

1Department of Preventive and Social Dentistry, College of Dentistry, Kyung Hee University, Seoul, Korea

2Department of Preventive Dentistry, College of Dentistry, Gangneung-Wonju University, Gangneung, Korea

3Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University, Seoul, Korea

4Department of Preventive and Social Dentistry, Graduate School, Kyung Hee University, Seoul, Korea

Corresponding Author: Ji-Eun Jeon Department of Preventive and Social Dentistry, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: +82-2-961-0344 Fax: +82-2-961-9594 E-mail: 2006707019@hanmail.net https://orcid.org/0000-0002-2856-281X

Received 22 May 2019       Revised 11 July 2019       Accepted 30 July 2019

Copyright © 2019 by 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/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study aimed to estimate the financial budget of light-curing composite resin fillings based on the expanded coverage of the National Health Insurance Service (NHIS), called “Moon Care.”

Methods

The estimated population with dental caries and the amount of light-curing composite resins used were determined. The fees for the resin fillings per tooth were considered for the calculations. The expected budget for the next five years for children and adolescents aged 5-12 and 5-19 years were calculated.

Results

During the first year of the coverage, the budget for children and adolescents aged <19 years was estimated to be 201.8 billion South Korean won (5-9 years, 17.9 billion South Korean won; 10-14 years, 76.6 billion South Korean won; and 15-19 years, 107.3 billion South Korean won). The total budget for the next five years for children and adolescents aged <19 years was estimated at 946.4 billion South Korean won. Likewise, the budget for children aged <12 years during the first year of the coverage was estimated at 63.9 billion South Korean won (5-9 years, 17.9 billion South Korean won and 10-12 years, 46 billion South Korean won), and the total budget for the next five years was estimated at 315.9 billion South Korean won.

Conclusions

Government healthcare plans should be established based on treatment needs and financial estimations. All the items in the NHIS, including the light-curing composite resin filling, should be considered based on their contribution to oral health promotion. Furthermore, in the long term, the coverage for preventive health services should be included in the health insurance.

Keywords: Children, Dental caries, Financial estimation, Health insurance, Light-curing composite resin

References

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Table 1.
Estimated total population of 5-19 years old and population covered by National Health Insurance (NHI)
Estimated total population 2019 2020 2021 2022 2023
Total 7,195,461 7,013,831 6,839,654 6,734,221 6,663,506
5-9 yrs 2,281,130 2,276,836 2,218,597 2,155,940 2,101,559
10-14 yrs 2,243,982 2,244,607 2,290,682 2,308,220 2,288,826
15-19 yrs 2,670,349 2,492,388 2,330,375 2,270,061 2,273,121
Estimated population covered by NHI* 2019 2020 2021 2022 2023
Total 7,052,532 6,874,510 6,703,793 6,600,454 6,531,144
5-9 yrs 2,235,818 2,231,609 2,174,527 2,113,115 2,059,814
10-14 yrs 2,199,408 2,200,021 2,245,180 2,262,370 2,243,361
15-19 yrs 2,617,306 2,442,880 2,284,085 2,224,969 2,227,968
Estimated population visiting dental clinic† 2019 2020 2021 2022 2023
Total 2,031,129 1,979,859 1,930,692 1,900,931 1,880,969
5-9 yrs 643,916 642,704 626,264 608,577 593,226
10-14 yrs 633,430 633,606 646,612 651,563 646,088
15-19 yrs 753,784 703,549 657,816 640,791 641,655

*Estimated population covered by NHI=Estimated total population×98.0% (Percentage of people covered by NHI in 2015).

† Estimated population visiting dental clinic=Estimated population covered by NHI×28.8% (Percentage of people visiting dental clinic by Korean Health Panel data).

Table 2.
Estimated mean number of DT and FT of 5-19 years old and population
Estimated mean number of DT and FT 2019 2020 2021 2022 2023
8 yrs (5-9 yrs)* 0.37 0.33 0.30 0.28 0.25
12 yrs (10-14 yrs)† 1.59 1.45 1.32 1.21 1.10
15 yrs (15-19 yrs)* 1.82 1.62 1.45 1.30 1.16

*Data from Korea National Health and Nutrition Examination Survey (KNHANES).

† Data from Korean Children’s Oral Health Survey (KCOHS).

Table 3.
Estimation population to visit dental clinic and the amount of use of light-curing composite resin (2019)
Age (group) Estimated population with dental caries (person) Number of teeth required for dental caries treatment* (number) Amount of use of light-curing composite resin† (number)
5-19 yrs Total 2,031,129 2,612,570 2,147,532
5- 9 yrs 643,916 235,040 193,203
10-14 yrs 633,430 1,004,966 826,082
15-19 yrs 753,784 1,372,563 1,128,247
5-12 yrs Total 1,023,973 838,020 688,852
5- 9 yrs 643,916 235,040 193,203
10-12 yrs 380,058 602,980 495,649

*Number of teeth required for dental caries treatment=Estimated population with dental caries×Estimated number of teeth for treatment of dental caries (10-12 years of age apply to 3/5 percent of 10-14 years of age).

† Amount of use of light-curing composite resin=Number of teeth required for dental caries treatment×Use ratio of light-curing composite resin (82.2%).

Table 4.
Total amount of amalgam used per tooth surface by year (5-19 yrs)
Surfaces Total amount of amalgam used (number)
2014 2015 2016 2017 2018 Total (%)
Total 805,285 667,068 549,809 452,973 359,629 2,802,477 (100.0)
1 253,874 200,700 156,519 121,812 91,763 824,668 (29.4)
2 479,964 403,274 337,852 282,639 232,731 1,736,460 (62.0)
≥3 71,447 63,094 55,438 48,522 35,135 241,349 (8.6)
Table 5.
Calculation process of application fee of light-curing composite resin per tooth (5-19 yrs)
Surfaces Percentage of composite resin per tooth (%) Fee for composite resin filling (won) The estimated average fee for composite resin (won)
Total 100.0 86,369 85,309
1 29.4 81,267
2 62.0 86,373
≥3 8.6 91,468
Table 6.
Financial estimates of children and adolescents under the age of 19 in the first year of coverage
Age Division Amount of use of light-curing composite resin (number) Out-of-pocket payment 30% (million) Insurance benefit 70% (million) Total budget 100% (million)
5-19 yrs Total 2,147,532 54,762 127,778 182,540
5-9 yrs 193,203 4,927 11,496 16,422
10-14 yrs 826,082 21,065 49,152 70,217
15-19 yrs 1,128,247 28,770 67,131 95,901
5-12 yrs Total 688,852 17,566 40,987 58,552
5-9 yrs 193,203 4,927 11,496 16,422
10-12 yrs 495,649 12,639 29,491 42,130

The average fee per light-curing composite resin: 85,000 won.

Table 7.
Financial estimates for children and adolescents under 19 years of age over the next five years (2019-2023)
Age Year Amount of use of light-curing composite resin (number) Out-of-pocket payment 30% (million) Insurance benefit 70% (million) Total budget 100% (million)
5-19 yrs Total 8,447,066 215,400 502,600 718,001
2019 2,147,532 54,762 127,778 182,540
2020 1,867,740 47,627 111,131 158,758
2021 1,641,787 41,866 97,686 139,552
2022 1,467,770 37,428 87,332 124,760
2023 1,322,236 33,717 78,673 112,390
5-12 yrs Total 2,897,957 73,898 172,428 246,326
2019 688,852 17,566 40,987 58,552
2020 628,418 16,025 37,391 53,416
2021 578,150 14,743 34,400 49,143
2022 527,048 13,440 31,359 44,799
2023 475,489 12,125 28,292 40,417

The average fee per light-curing composite resin: 85,000 won.

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