Did Expanded Dental Insurance Reduce Out-of-Pocket Expenditures on Dental Care among Older Adults in Korea? Interrupted Time-Series Analysis.

Nam-Hee Kim,Ichiro Kawachi,Se-Hwan Jung

doi:10.3390/ijerph18063003

Abstract

The Korean National Health Insurance extended its coverage to reduce the economic burden of receiving dentures and implants for older adults in 2012 and 2014, respectively. We examined whether the new policy resulted in reduced out-of-pocket dental care expenditure in the eligible population, specifically focusing on low-income adults. We used interrupted time-series analysis (ITSA), a quasi-experimental design, to identify the effects of the policy among persons aged 65 or older. Data were extracted from the Korea Health Panel Survey (KHP; 2008–2017). The main outcome was out-of-pocket expenditures on dental care. The ITSA showed that expenditures decreased annually by 4.5% (RR: 0.96, 95% CI: 0.95–0.96) between 2012 and 2014. However, expenditure increased by 7.8% (RR: 1.08, 95% CI: 1.07–1.08) after 2014. Dental insurance coverage did not contribute to reducing the out-of-pocket expenses for dentures among low-income adults, while coverage of dental implants led to an increase in dental expenditure.

Highlights

In many countries, dental care is not included in universal insurance coverage
We evaluated whether the expansion of dental insurance for older adults to cover denture and dental implant services led to a reduction in dental care expenditures, focusing on people with low incomes in South Korea
In the multi-group interrupted time-series analysis (ITSA) model, we found that annual expenditures on dental care significantly increased by 97,155 KRW in those aged 65 years or older with the lowest income following the 2014 intervention (β7: 95% CI: 7028 to187,283, p < 0.05)

Summary

Introduction

Dental care is not included in universal insurance coverage. this leads to the social burden of disease that will need to be addressed by health insurance that covers essential oral health care [1,2,3].The Korean government expanded dental insurance for older adults to cover denture services in 2012, and dental implants in 2014. Dental care is not included in universal insurance coverage. This leads to the social burden of disease that will need to be addressed by health insurance that covers essential oral health care [1,2,3]. The Korean government expanded dental insurance for older adults to cover denture services in 2012, and dental implants in 2014. These steps were expected to reduce the economic barriers to dental care. 50–70% of their out-of-pocket expenditures for dental prosthetic treatment Such treatment may have continued to be unavailable to people with limited financial resources due to high costs [4,5]. The average monthly income of older adults in Korea is less than 1000 USD [6]; they still need to pay approximately

Methods

Results

Conclusion