The Impact of the SARS Epidemic on the Utilization on Dental care under NHI system

• Main Authors: CHUAN-JUNG KUNG, 龔川榮
• Other Authors: Shun-Te Huang
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/85092168460547160697

碩士 === 高雄醫學大學 === 口腔衛生科學碩士在職專班 === 92 === Background：The endemic of Severe Acute Respiratory Syndrome （SARS） had a great impact on the health care delivery system of Taiwan in the year 2003, and also affected the health care utilization of the beneficiaries of the National Health Insurance. Dentists must be in close contract with patients, and could be exposed to the risk factor of breathing the air of a SARS patient. This study was to explore the changes of utilization of the items of specific dental care and the number of visit in the endemic period of SARS. Study objective：The purpose of this study involved two tasks: 1. The difference in the utilization of dental care and the claims of dental care fees among various districts and health care providers in the endemic period of SARS 2. The study examined whether the items of specific dental care were influenced by the categories of dental care urgency. Method：The utilization of dental care and the number of visits were collected from the claims of dental care fees from the Bureau of Health Insurance in the years of 2001,2002 and 2003. Descriptive statistics ,two sample t-test, analysis of variance and multiple regression were used to investigate the relationship among the variables in the nineteen weeks of the pre-SARS period 、SARS endemic period and post- SARS period , the same period between SARS endemic period in 2003 and non- SARS endemic period in 2002. Result：1.We found that the number of visits and the dental claim fee per week decreased in the SARS endemic period. Moreover the differences were observed in all levels of dental care institutions and the NHI districts. The degree of decrease in the utilization was that the post- SARS period was greater than the pre-SARS period ,and the least in the SARS endemic period. The two sample t-test in contracted category, academic medical centers, metropolitan hospitals and local community hospitals reduced by 20 to 30%, dental clinics only a small decrease. 2.The two sample t-test in five items of specific dental care shoned a small increase in endodontic treatment, and reduction amalgam restoration 16.38%, scaling 7.45%. 3.The dental care urgent degrees were in the decreasing order of : endodontics ＞teeth composite resin restoration＞extraction＞scaling＞amalgam restoration. Conclusion：Our results showed obvious differences during the endemic period of SARS in the utilization of dental care 、the claim of dental care fees and the items of specific dental care. These results could serve as the base for a review of the global budget of dental care and fee schedule of dental care in the period of a speacific endemic disease.