Health economic evaluation methods for decision-making in preventive dentistry

The objectives of this dissertation were to assess caries-preventive steps from a societal viewpoint, to show the application of resources in preventive dental care, to formulate and explore approaches ideal for analyzing dentistry expenses and results, and also to examine costs and effects within a health economic decision model tailored to preventive dental care. The dissertation is dependant on 3 individual researches with 3 individual cohorts. In the initial research, carried out at a one dental clinic, investigation was done of data on dental caries progression over 4 years in Ninety two young people, combined with use of resources for precautionary treatment. In the next research, data from the intervention study “Evaluation of caries-preventive measures” (performed between 1995 and 1999 at Twenty six dental health centers were utilised for economic evaluation. About three distinct methods to determining unit cost were reviewed, each of which represent the variations in treatment costs as affected by the practitioner’s skill level and competence (salary) and also by ways of dealing with overhead cost allocation…

Contents: Health economic evaluation methods for decision-making in preventive dentistry

1. INTRODUCTION AND BACKGROUND
1.1 THE DECISION-MAKING PROCESS: THE ANALYST AND THE DECISION-MAKER
2. HEALTH AS AN OUTCOME
2.1 HEALTH
2.2 QUALITY OF LIFE
2.3 HEALTH, ORAL HEALTH, AND QUALITY OF LIFE
2.4 OUTCOME MEASUREMENT
2.5 ORAL HEALTH-RELATED QUALITY OF LIFE MEASURES
3. AN ECONOMICAL FRAMEWORK FOR EVALUATION
3.1 HEALTH CARE AS AN ECONOMIC COMMODITY
3.2 SIMILARITIES AND DIFFERENCES IN DENTAL HEALTH CARE AND MEDICAL HEALTH CARE
3.3 DIFFERENT TYPES OF ECONOMIC EVALUATION
3.4 ECONOMIC EVALUATIONS IN THE DENTAL HEALTH CARE LITERATURE
3.4.1 Costs
3.4.2 Outcome measure in preventive dentistry
3.4.3 Cost minimisation analysis
3.4.4 Cost-effectiveness analysis
3.4.5 Cost-utility analysis
3.4.6 Cost-benefit analysis
4. DENTAL CARIES AND THE CARIES–PREVENTIVE PROJECT
4.1 PREVENTION OF DENTAL CARIES
4.2 THE CARIES-PREVENTIVE PROJECT
4.3 ECONOMIC EVALUATION IN “HEALTH CARE ENTERPRISES”
5. AIMS
5.1 ITS SPECIFIC AIMS WERE:
6. SUBJECTS AND METHODS
6.1 USE OF RESOURCES FOR PREVENTION OF DENTAL CARIES
6.2 EVALUATION OF DENTAL CARE COSTS
6.3 COST-EFFECTIVENESS OF CARIES-PREVENTIVE MEASURES
6.4 ORAL HEALTH-RELATED QUALITY OF LIFE MEASURES IN CARIES PREVENTIVE CARE
6.4.1 Subjects and data collection:
6.5 VALUATION OF CARIES PREVENTIVE CARE
6.6 SENSITIVITY ANALYSIS
6.6.1 Incremental CEA in the five-year follow-up
6.7 DIFFERENTIAL TIMING OF COSTS AND CONSEQUENCES
6.8 STATISTICAL METHODS
7. RESULTS
7.1 USE OF RESOURCES FOR PREVENTION OF DENTAL CARIES – COST CALCULATION
7.2 EVALUATION OF DENTAL CARE COSTS
7.2.1 Distribution of treatment time and cost elements
7.2.2 Unit cost calculation
7.2.3 Sensitivity analysis for cost calculation
7.2.4 Comparison of costs and charges
7.3 COST-EFFECTIVENESS OF CARIES-PREVENTIVE MEASURES
7.3.1 Outcome
7.3.2 Costs
7.3.3 Cost-effectiveness analysis
7.3.4 Sensitivity analysis for the CEA
7.4 OHRQOL MEASURES IN CARIES PREVENTIVE CARE
7.4.1 CPQ11-14 and OHIP-14
7.4.2 Global rating of overall well-being
7.5 VALUATION OF CARIES PREVENTIVE CARE
7.5.1 Elicitation of willingness to pay (WTP) and Cost-Benefit Analysis (CBA)
7.5.2 VOSOH-ITS (Value Of Statistical Oral Health-intact tooth surface)
8. DISCUSSION
8.1 RELIABILITY AND VALIDITY
8.1.1 Treatment time
8.1.2 Cost calculations
8.1.3 Caries increment in the CEA study
8.1.4 Measurement of oral health-related quality of life (OHRQOL) and elicitation of willingness to pay (WTP)
8.2 HEALTH ECONOMIC ANALYSIS IN CARIES-PREVENTIVE RESEARCH
8.2.1 Cost-effectiveness of caries-preventive measures
8.2.2 Cost-benefit analysis of caries-preventive measures
8.3 OUTCOME
8.3.1 OHRQOL as a supplemental measure in economic analysis
8.3.2 VOSOH-ITS (Value Of Statistical Oral Health-intact tooth surface )
8.4 WHAT IS THE SCOPE FOR THE DENTAL HEALTH CARE DECISION-MAKER?
8.4.1 Organisation of dental clinics…

Source: Umea University

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