National dental policies and socio-demographic factors affecting changes in the incidence of periodontal treatments in Korean: A nationwide population-based retrospective cohort study from 2002-2013.
BACKGROUND
Dental insurance coverage has recently expanded in Korea. The number of patients diagnosed with periodontal disease (PD), and the actual number of periodontally compromised patients has increased. However, few studies have investigated the relationships between the prevalence of periodontal disease and the incidence of PD treatment, dental insurance policies, and socio-demographic factors. To determine the incidence of periodontal treatments required, the comprehensive longitudinal data of the National Health Insurance Service were used. This study evaluated changes in the incidence of periodontal treatments, using data from the Korean National Health Insurance Cohort Database.


METHODS
A random stratified sample of 1,025,340 Korean patients was selected from National Health Insurance database, using 1,476 multistage samplings (of sex, age, and income level) for 12 years from 2002 to 2013. Chi-square analysis, and univariate, and multivariate logistic regression were used to evaluate the association of socio-demographic factors with the prevalence of PD and the incidence of periodontal treatment.


RESULTS
The incidence of periodontal treatment steadily and significantly increased, in both male and female participants, from 2002 to 2013. The increase was associated with socio-demographic factors and changes in national dental insurance policies. The incidence of periodontal treatment evaluated by age is influenced by the changes in national dental policies. These results suggest that the increase in patients diagnosed with PD reflects changes in dental policies and insurance benefits.


CONCLUSIONS
This study confirms that national dental policies and socio-demographic factors are related to the incidence of periodontal treatments. The incidence of periodontal treatment is significantly related to the expansion of insurance coverage in South Korea.
Department of Periodontology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, 35233, South Korea.
Jae-Hong
JH
Lee
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Jung-Seok
JS
Lee
Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, 10444, South Korea.
Jung-Kyu
JK
Choi
Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea.
Hye-In
HI
Kweon
Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea. youngtaek77@naver.com.
Young-Taek
YT
Kim
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. shchoi726@yuhs.ac.
Seong-Ho
SH
Choi
D003729:Dental Care; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010510:Periodontal Diseases / Q000453:epidemiology / Q000628:therapy*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
Cohort analysis; Dental insurance; Health insurance; Health services accessibility; Periodontal disease