아동치과주치의 시범사업 성과평가 -도입 2차 연도 중심

Abstract

Since May 2021, the Korean government has introduced the 'Child Dental Clinic Pilot Project' as a prevention-focused continuous oral care project to improve children's oral health and has been operating it for three years. The pilot project is scheduled to end in May 2024, and a performance evaluation of the pilot project must be conducted. The purpose of this study is to evaluate the performance of the pilot project after the second year of its introduction and to prepare ways to improve the pilot project in the future. In this study, the system of the pilot project was reviewed, the performance of the pilot project was evaluated through selection of a pilot project performance evaluation model and analysis of evaluation indicators, and improvement measures for the pilot project were reviewed. National Health Insurance Claims Database (NHICD) collected by the Health Insurance Review & Assessment Service (HIRA) and the Child Dental Clinic Pilot Project Registry were linked and analyzed to calculate the evaluation indicators. A survey of participants was conducted to determine satisfaction with the project and improvement plans. As a result of the pilot project performance evaluation, in terms of accessibility, the participation rate of children in the pilot project was 24.5%, an increase from 18.8% in the first year, but the proportion of children who participated only once was high at 43.5%, so children's continuous participation was necessary. In terms of quality of medical care, parents' satisfaction with the pilot project was 84.7 points, an increase of 2.2 points compared to last year, and attending physicians' satisfaction was 74.5 points. In terms of medical care utilization, the dental medical care use of children who participated in the pilot project increased by 21.9% after the project compared to before the project, while that of children who did not participate decreased by 14.0%. The proportion of dental caries diagnoses among children who participated in the pilot project decreased by 1.5%p, and increased by 2.6%p among children who did not participate. The proportion of preventive services for children who participated in the pilot project increased by 1.3%p, a larger increase than for children who did not participate (0.9%p). Although the number of dental visits among children in Korea decreased during the pilot project period due to the impact of the COVID-19 infectious disease, participation in the pilot project increased opportunities for regular dental visit habits, while reducing the proportion of dental caries. In terms of effectiveness, children who continuously participated in the pilot project had a 1.3%p decrease in negative perception of oral health, improved oral health awareness, and a 4.5%p increase in the rate of correct snack consumption habits. In terms of oral health, the PHP index score of children who continued to participate in the pilot project improved by 17.5%, improving oral hygiene, and the permanent tooth caries prevalence decreased by 4.6%p and the permanent tooth caries rate decreased by 15.6%p, improving oral health. In addition, the proportion of respondents who responded that their oral-related quality of life was ‘good’ also increased by 3.9%p, confirming the improvement effect of the pilot project on oral health. As a result of reviewing the improvement plan for the pilot project, the plan to expand the target age for the pilot project should be decided by considering the effectiveness of the project for children in lower grades. There were many opinions on applying the cavity treatment service to the pilot project, but agreement on the scope of the service is needed. Improvement of publicity is necessary to revitalize the pilot project, and improving the level of service provision is a priority rather than reducing patients' out-of-pocket costs.