periodontal treatment ; the adjusted insurance reimbursement review system of periodontal treatment
Abstract
The purpose of this study was to investigate awareness of dentists in the adjusted insurance reimbursement review system of periodontal treatment(AIRRSP) for evaluating a operation of this system after one year and to suggest the improvement system on periodontal related dental insurance claim. The results of this study were as followed:
1. In the participant motive of AIRRSP, the 73.3% answered that they wanted to treat for their own opinion, the 21.0% answered that they avoided disadvantage such as inspection, the 4.8% answered that they just followed other dentists, and the 0.9% answered that they were with no definite idea.
2. In the enforcement effect of AIRRSP, the 50.0%% answered that they can actively treat patients who need the periodontal treatment, the 68.6% answered that a frequency of periodontal treatment was virtually increased after operating this system, and. the 69.6% answered that the sliding scale of periodontal treatment was converted to prospective insurance coverage of periodontal treatment. Thus, they had positive opinion in the AIRRSP. However, the only 9.1% answered that self-regulating guidance and actual inspection were to be free.
3. In the general evaluation of AIRRSP, the 68.6% of participant group answered that they contributed positively on normalization of periodontal treatment and the 21. 3% answered in the non-participant group.
4. In the future, even though AIRRSP is to be continued same as at present, the opinion that anybody could join a member was 76.3% in the participant group, and 68.3% in the non-participant group. Most of their opinion was that improve more logically their present policy.
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5. In the analysis of the health insurance review agency, treatment fee payment status of both participant dental clinic and non-participant dental clinic in 1999 was that participant dentists had higher than nonparticipant dentists. Total requesting case was 742thousand case(38.2%), total treatment fee was 274billon7,400won(62.9%), each case of treatment fee was 4,019(17.9o%)won, total treatment fee was 6,421(79.9%)won.
In conclusion, we can consider that periodontal treatment in dental clinics was activated by the enforcement of AIRRSP. Furthermore, if AIRRSP is compliment through a positive publicity and a systematic improvement, it will be a desirable system for solving a distorted condition of public oral health promotion.