민간 치과의료보험과 치과의료이용 경험에 대한 질적 사례연구

초록

This study aims to provide supplementary evidence for national policies to enhance universal oral health coverage and improve access to dental care. It explores the perceptions and experiences of private dental insurance subscribers and examines changes in dental care utilization before and after insurance enrollment. Semi-structured interviews were conducted with 12 adults divided into three groups: those currently enrolled in private dental insurance, those who canceled their subscriptions, and those who never subscribed. The interview scripts were analyzed using a qualitative case study approach to explore participants’ lived experiences and perceptions. Many participants enrolled in private dental insurance due to financial difficulties in affording dental care. After enrollment, they found it helpful in alleviating their actual financial burden, leading to an increase in dental care utilization. However, issues such as unequal access, misinformation from insurance agents, difficulties in claiming reimbursements, and a lack of understanding of compensation regulations were reported. Participants expressed a preference for national health insurance to address these problems. The study identified key issues in private dental insurance, such as inequalities in subscriber selection, misinformation, lack of understanding of compensation regulations, and complex reimbursement claim procedures. Addressing these challenges and improving the reimbursement criteria for private dental insurance are crucial to reducing disparities in dental care utilization and enhancing national health insurance policies for dental healthcare coverage.

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