Cargando…

Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis

BACKGROUND: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults. METHODS: We compared data before and after policy implementation usi...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Nam-Hee, Elani, Hawazin W., Kawachi, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Epidemiological Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794449/
https://www.ncbi.nlm.nih.gov/pubmed/34121050
http://dx.doi.org/10.2188/jea.JE20200596
_version_ 1784860037779292160
author Kim, Nam-Hee
Elani, Hawazin W.
Kawachi, Ichiro
author_facet Kim, Nam-Hee
Elani, Hawazin W.
Kawachi, Ichiro
author_sort Kim, Nam-Hee
collection PubMed
description BACKGROUND: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults. METHODS: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016–2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group. RESULTS: Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals using DDD analysis, we found that the insurance expansion led to a 21.6% smaller increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI, −35.0 to −8.5; P < 0.01). CONCLUSION: Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a smaller increase in unmet dental needs among low-income older adults, compared to high-income adults.
format Online
Article
Text
id pubmed-9794449
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Japan Epidemiological Association
record_format MEDLINE/PubMed
spelling pubmed-97944492023-02-06 Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis Kim, Nam-Hee Elani, Hawazin W. Kawachi, Ichiro J Epidemiol Original Article BACKGROUND: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults. METHODS: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016–2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group. RESULTS: Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals using DDD analysis, we found that the insurance expansion led to a 21.6% smaller increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI, −35.0 to −8.5; P < 0.01). CONCLUSION: Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a smaller increase in unmet dental needs among low-income older adults, compared to high-income adults. Japan Epidemiological Association 2023-02-05 /pmc/articles/PMC9794449/ /pubmed/34121050 http://dx.doi.org/10.2188/jea.JE20200596 Text en © 2021 Nam-Hee Kim et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Kim, Nam-Hee
Elani, Hawazin W.
Kawachi, Ichiro
Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title_full Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title_fullStr Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title_full_unstemmed Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title_short Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis
title_sort did dental insurance expansion improve dental care needs among korean adults? difference in difference analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794449/
https://www.ncbi.nlm.nih.gov/pubmed/34121050
http://dx.doi.org/10.2188/jea.JE20200596
work_keys_str_mv AT kimnamhee diddentalinsuranceexpansionimprovedentalcareneedsamongkoreanadultsdifferenceindifferenceanalysis
AT elanihawazinw diddentalinsuranceexpansionimprovedentalcareneedsamongkoreanadultsdifferenceindifferenceanalysis
AT kawachiichiro diddentalinsuranceexpansionimprovedentalcareneedsamongkoreanadultsdifferenceindifferenceanalysis