Abstract：
OBJECTIVE: To study the use of a quasi-experimental design to assess the effects of scaling reimbursement policies on the incidence of chronic-periodontitis procedures.
METHODS: Interrupted time series analysis was used to compare the effects before and after policy implementation using data on the number of periodontitis-related procedures from the Korean National Health Insurance Service-National Sample Cohort (n = 740,467) and the Health Screening Cohort (n = 337,904). Periodontitis-related procedures with diagnosis codes were categorized into basic (scaling or root planing), intermediate (subgingival curettage) and advanced (tooth extraction, periodontal flap surgery, bone grafting for alveolar bone defects or guided tissue regeneration). Subjects\' demographics and comorbidities were considered. The incidence rate of immediate changes and gradual effects before and after policy implementation was assessed.
RESULTS: Following the policy implementation from July 2013, an immediate increase was observed in total and basic procedures. No significant changes were noted in intermediate and advanced procedures initially. A decrease in the slope of intermediate procedures was observed in both databases. Advanced procedures showed varied trends, with no change in the National Sample Cohort but an increase in the Health Screening Cohort, particularly among subjects with comorbidities.
CONCLUSIONS: Following the new policy implementation, the number of intermediate procedures decreased while the number of advanced procedures increased, especially among patients with comorbidities. These findings offer valuable insights on policy evaluation.
METHODS: Interrupted time series analysis was used to compare the effects before and after policy implementation using data on the number of periodontitis-related procedures from the Korean National Health Insurance Service-National Sample Cohort (n = 740,467) and the Health Screening Cohort (n = 337,904). Periodontitis-related procedures with diagnosis codes were categorized into basic (scaling or root planing), intermediate (subgingival curettage) and advanced (tooth extraction, periodontal flap surgery, bone grafting for alveolar bone defects or guided tissue regeneration). Subjects\' demographics and comorbidities were considered. The incidence rate of immediate changes and gradual effects before and after policy implementation was assessed.
RESULTS: Following the policy implementation from July 2013, an immediate increase was observed in total and basic procedures. No significant changes were noted in intermediate and advanced procedures initially. A decrease in the slope of intermediate procedures was observed in both databases. Advanced procedures showed varied trends, with no change in the National Sample Cohort but an increase in the Health Screening Cohort, particularly among subjects with comorbidities.
CONCLUSIONS: Following the new policy implementation, the number of intermediate procedures decreased while the number of advanced procedures increased, especially among patients with comorbidities. These findings offer valuable insights on policy evaluation.
摘要：
目的：研究使用准实验设计来评估缩放补偿政策对慢性牙周炎发生率的影响。
方法：使用来自韩国国家健康保险服务-国家样本队列（n=740,467）和健康筛查队列（n=337,904）的牙周炎相关程序的数量数据，使用中断时间序列分析来比较政策实施前后的效果。具有诊断代码的牙周炎相关程序被分类为基本（缩放或根部平整），中级(龈下刮治)和高级(拔牙，牙周皮瓣手术,骨移植治疗牙槽骨缺损或引导组织再生）。考虑了受试者的人口统计学和合并症。评估了政策实施前后的即时变化和渐进影响的发生率。
结果：从2013年7月开始实施政策后，观察到总体和基本程序立即增加。最初在中级和高级程序中没有发现重大变化。在两个数据库中都观察到中间程序的斜率降低。先进的程序显示出不同的趋势，国家样本队列没有变化，但健康筛查队列增加了，特别是在有合并症的受试者中。
结论：在新政策实施之后，中间程序的数量减少，而高级程序的数量增加，尤其是有合并症的患者。这些发现为政策评估提供了宝贵的见解。
方法：使用来自韩国国家健康保险服务-国家样本队列（n=740,467）和健康筛查队列（n=337,904）的牙周炎相关程序的数量数据，使用中断时间序列分析来比较政策实施前后的效果。具有诊断代码的牙周炎相关程序被分类为基本（缩放或根部平整），中级(龈下刮治)和高级(拔牙，牙周皮瓣手术,骨移植治疗牙槽骨缺损或引导组织再生）。考虑了受试者的人口统计学和合并症。评估了政策实施前后的即时变化和渐进影响的发生率。
结果：从2013年7月开始实施政策后，观察到总体和基本程序立即增加。最初在中级和高级程序中没有发现重大变化。在两个数据库中都观察到中间程序的斜率降低。先进的程序显示出不同的趋势，国家样本队列没有变化，但健康筛查队列增加了，特别是在有合并症的受试者中。
结论：在新政策实施之后，中间程序的数量减少，而高级程序的数量增加，尤其是有合并症的患者。这些发现为政策评估提供了宝贵的见解。
