The most comprehensive study of US community water fluoridation program benefits and costs was published in 2001. This study provides updated estimates using an economic model that includes recent data on program costs, dental caries increments, and dental treatments. In 2013 more than 211 million people had access to fluoridated water through community water systems serving 1,000 or more people. Savings associated with dental caries averted in 2013 as a result of fluoridation were estimated to be $32.19 per capita for this population. Based on 2013 estimated costs ($324 million), net savings (savings minus costs) from fluoridation systems were estimated to be $6,469 million and the estimated return on investment, 20.0. While communities should assess their specific costs for continuing or implementing a fluoridation program, these updated findings indicate that program savings are likely to exceed costs.
Differences in disease burden and access to outpatient services may partly explain the higher PPH rates for AI/AN Medicare enrollees. The health care quality measure used in this study (PPH) was developed for the US general population. It is important to consider AI/AN socioeconomic and other characteristics when interpreting findings for such measures and enhancing programs and policies to improve AI/AN health outcomes.
Hospital-acquired conditions such as catheter-associated urinary tract infection, stage 3 or 4 hospital-acquired pressure injury, and falls with injury are common, costly, and largely preventable. This study used participatory design methods to design and evaluate low-fidelity prototypes of clinical dashboards to inform high-fidelity prototype designs to visualize integrated risks based on patient profiles. Five low-fidelity prototypes were developed through literature review and by engaging nurses, nurse managers, and providers as participants (N = 23) from two hospitals in different healthcare systems using focus groups and interviews. Five themes were identified from participatory design sessions: Need for Integrated Hospital-Acquired Condition Risk Tool, Information Needs, Sources of Information, Trustworthiness of Information, and Performance Tracking Perspectives. Participants preferred visual displays that represented patient comparative risks for hospital-acquired conditions using the familiar design metaphor of a gauge and green, yellow, and red “traffic light” colors scheme. Findings from this study were used to design a high-fidelity prototype to be tested in the next phase of the project. Visual displays of hospital-acquired conditions that are familiar in display and simplify complex information such as the green, yellow, and red dashboard are needed to assist clinicians in fast-paced clinical environments and be designed to prevent alert fatigue.
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