Systematic Review of Economic Evaluations of Primary Caries Prevention in 2- to 5-Year-Old Preschool Children

Anopa, Yulia; Macpherson, L.M.D.; McIntosh, Emma

doi:10.1016/j.jval.2020.04.1823

Cited by 10 publications

(24 citation statements)

References 56 publications

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“…Untreated dental caries is a prevalent chronic disease especially in children with significant economic burden globally 16,19,20 . Therefore, preventive measures for caries is especially critical in rural settings such as those discussed in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…More specifically, the present study investigates forecasting four preventive DQMs with a focus on caries prevention (Adult New Caries, Sealants (6-9yrs), Sealants (12-15yrs), Fluoride Varnish) averaged across the ten FHC dental centers from (Dec. 2010 to July 2017) using time series models. Dental caries has been associated with significant economic burden 16,19,20 . National Center for Statistics 2018 report indicates 16.9% of children (5-19 yrs.)…”

Section: Introductionmentioning

confidence: 99%

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Forecasting Preventive Dental Quality Measures

Nagarajan

Panny

Ryan³

et al. 2021

Preprint

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Dental quality measures objectively measure the efficiency and performance of dental providers and organizations. While these measures in conjunction with established benchmarks are used routinely for self-assessment, forecasting them ahead of time in a data-driven and evidence-based manner has the potential to assist in assessing future dental treatment needs, oral disease burden, care utilization patterns, and strategic decision making for sustained performance improvement complementing traditional descriptive visualization dashboards. The present study modeled the temporal trends of four key preventive dental quality measures related to caries prevention (Adult New Caries, Sealants (6-9yrs.), Sealants (12-15yrs.), Fluoride Varnish) sampled monthly from (Dec. 2010 to July 2017) averaged across ten Family Health Center Dental Centers (FQHC), Wisconsin, using auto-regressive integrated moving average time series models. Five-month ahead forecasts along with their 95% confidence levels and mean absolute percentage error were determined across the four measures (Adult New Caries: 1.8%, Sealants (6-9yrs.): 0.90%, Sealants (12-15yrs.): 0.30%, Fluoride Varnish: 0.15%). Model diagnostics revealed auto-regressive integrated moving average models to sufficiently capture the temporal patterns of these measures and the forecast estimates of Adult New Caries and Sealants (12-15yrs.) revealed the need for increased efforts for improved preventive care utilization. Forecasting preventive dental quality measures can provide insights into expected treatment needs ahead of time and can assist in optimal resource and staff allocation with potential to prescribe suitable interventions to shift the trajectory from predicted outcomes to desired outcomes in a targeted manner. While the present study investigated organization level preventive dental quality measures, the time series approach presented is as such generic and expected to translate across similar settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Forecasting Preventive Dental Quality Measures

Nagarajan

Panny

Ryan³

et al. 2021

Preprint

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“…A CEA is appropriate to inform decisions because it maintains health outcomes in its natural units rather than monetizing the outcomes [ 18 , 21 , 22 ]. Cost-effectiveness results can be expressed in costs per natural health units such as USD per the T-Health index or a cost-effectiveness ratio (CER) [ 16 ]. This study did not take into account the cost of loss of productivity and travel cost, so the cost-effectiveness of EDV and non-EDV compared by calculating the direct medical cost covered by insurance for five years after the infant oral examination, excluding the indirect cost.…”

Section: Methodsmentioning

confidence: 99%

“…Cost-effectiveness provides insight into the value of health interventions [ 16 ]. Findings of economic evaluations could help policy makers prioritize funding decisions.…”

Section: Introductionmentioning

confidence: 99%

The cost- effectiveness of early dental visit in infants and toddlers focused on regional deprivation in South Korea: A retrospective cohort study

Ahn

Kim²

2022

PLoS ONE

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Background The aims of this study are to evaluate the cost-effectiveness of early dental visits (EDVs) and to investigate how regional deprivation impacts the economic evaluation. Methods This study used the South Korea National Health Insurance database, which included medical claim data and voluntary-based oral examination data. The subjects of this study included whole participants for oral examinations for infants and toddlers of the National Health Insurance Corporation. A retrospective cohort study was designed and measured all oral treatments, costs, and number of visits for 208,969 children (experimental group, 101,768; non- experimental group, 107,201) who underwent oral examination for infants and toddlers from 2007 to 2014. The cost-effectiveness was measured using the incremental cost-effectiveness ratio, and the T-health index was used as the measurement for effectiveness. In addition, the difference in the effect according to the level of regional deprivation was confirmed. Results The findings of this study showed that EDVs were cost-effective and that children who participated in EDVs had better oral health (T-health-2 index difference 0.32 point in most deprived regions) and needed 5 USD less costly dental treatments than those who did not have EDVs. The cost-effectiveness of EDVs varied according to the level of regional deprivation and was the highest in the most deprived regions. Conclusions The study findings suggested that the provision of oral examination for infants and toddlers was a cost-effective dental policy. Additionally, EDVs were more effective in children who resided in the most deprived regions, a finding that will lead to the development of policy intervention to improve dental care despite spatial inequality for disadvantaged population groups. Regarding the distribution of dental hospitals/clinics, incentive based dental polices for either dental providers or patients are needed that will assure the delivery of dental care despite spatial inequality.

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“…Most economic evaluations we reviewed for dentistry did not adhere to the standards established for conduct of medical CEAs, such as the Drummond checklist, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, Phillip's checklist, The Gold Book, and the Second Panel on Cost-Effectiveness in Health and Medicine. 3 , 4 , 5 , 6 , 7 , 8 , 9 Key concerns with the quality of dental CEA research we found in our review include, but are not limited to, inconsistencies in the health benefit(s) measured with limited use of the generic measure of quality-adjusted life years (QALY), lack of consistent classification for oral diseases with inadequate descriptions of patient populations, and moderate to high risk of bias according to the various standards mentioned above. 3 , 4 , 5 , 6 , 7 , 8 , 9 Additional barriers include a lack of agreed-upon diagnosis codes and a dearth of easily accessible large-scale data.…”

mentioning

confidence: 99%