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Community Dent Oral Epidemiol. 2015 Dec;43(6):560-8. doi: 10.1111/cdoe.12181. Epub 2015 Jun 25.

Relative cost-effectiveness of home visits and telephone contacts in preventing early childhood caries.

Author information

1
Centre for Paediatric Dentistry, Oral Health Centre, The University of Queensland, Herston, Qld, Australia.
2
Oral Health Program (Logan-Beaudesert Division), Metro South Health, Logan City, Qld, Australia.
3
Centre for Applied Health Economics, Menzies Health Institute, Queensland, School of Medicine, Griffith University, Meadowbrook, Qld, Australia.
4
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.

Abstract

OBJECTIVES:

To evaluate the cost-effectiveness of a home-visit intervention conducted by oral health therapists relative to a telephone-based alternative and no intervention.

METHODS:

A Markov model was built to combine data on dental caries incidence, dental treatments, quality of life and costs for a cohort of children from age 6 months to 6 years. The probabilities of developing caries and subsequent treatments were derived primarily from the key intervention study. The outcome measures were costs (US dollars), quality-adjusted life years (QALYs) and the number of carious teeth prevented. One-way and probabilistic sensitivity analyses were used to test the stability of the model.

RESULTS:

For every group of 100 children, the model predicted that having the home-visit intervention would save $167 032 and telephone contacts $144 709 over 5½ years relative to no intervention (usual care). The home visits and telephone intervention would prevent 113 and 100 carious teeth (per 100 children) relative to no intervention in a period of 5½ years. Sensitivity analysis showed that a lower rate of caries reduced the intervention's cost-effectiveness primarily through reducing general anaesthesia costs. The home visits and telephone interventions resulted in 7 and 6 QALYs, respectively, gained over the usual care group for the 100 children over 5½ years. Both interventions were 'dominant,' as they saved costs and produced health benefits over usual care.

CONCLUSIONS:

Both the home visits and telephone-based community interventions conducted by oral health therapists were highly cost-effective than no intervention in preventing early childhood caries.

KEYWORDS:

Markov model; cost-effectiveness; early childhood caries; home-visit intervention; telephone intervention

PMID:
26110399
DOI:
10.1111/cdoe.12181
[Indexed for MEDLINE]

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