Impact of Reimbursement Expansion on Clinical Environment and Caregiver Satisfaction in Dental Care for Pediatric and Adolescent Patients with Disabilities: A Pilot Study at Yonsei University Dental Hospital

Abstract

This study aimed to investigate caregivers’ treatment satisfaction and clinical changes after the expansion of the additional reimbursement system for dental treatment for children with disabilities. A cross-sectional survey was conducted from April to May 2025 among 106 caregivers of pediatric patients with registered disabilities, including intellectual disability, brain lesion-related disabilities, and autism spectrum disorder. The 30-item questionnaire covered demographics, dental history, system awareness, clinical changes, and satisfaction. Statistical analyses included the Wilcoxon signedrank test, Fisher-Freeman-Halton exact test with Monte Carlo estimation, the binomial test, and the Poisson rate test, with the significance level set at α = 0.05. After expansion, the most common dental visit interval shifted from every 6 months to every 3 – 4 months (p < 0.0001). Caregivers reported improvements in treatment proactivity (p = 0.002) and treatment diversity (p < 0.0001), as well as overall satisfaction with dental care (p < 0.0001). This study suggests improvements in the clinical environment and satisfaction following the policy expansion. In the future, large-scale and longterm studies may help enhance the reliability of the findings and clarify their broader clinical implications.