Cost‐effectiveness of a disease management program for early childhood caries. (12th July 2014)

• Record Type: Journal Article
• Authors: Samnaliev, Mihail; Wijeratne, Rashmi; Grace Kwon, Eunhae; Ohiomoba, Henry; Wai Ng, Man
• Is Part Of: Journal of public health dentistry. Volume 75:Number 1(2015)
• Page Start: 24
• Page End: 33
• Publication Date: 2014-07-12
• Subjects: Dental public health -- Periodicals; 362.1976
• DOI: 10.1111/jphd.12067
• Languages: English
• ISSNs: 0022-4006

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jphd12067-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the cost‐effectiveness of a pilot disease management (DM) program aimed at preventing early childhood caries among children younger than 5 years.</p> </sec> <sec id="jphd12067-sec-0002" sec-type="section"> <title>Methods</title> <p>The DM program was implemented in the Boston Children's Hospital‐based dental practice in 2008. Health care costs were obtained from the hospital finance department and non‐health care costs were estimated through a parent survey. The measure of effectiveness was avoided hospital‐based visits for restorative treatment or extractions. Incremental costs (2011 US$) and effectiveness were estimated from a health care system, societal, and public payer perspectives over 3, 6, and 12 months, by comparing DM participants (<italic>n</italic> = 395) to a historical comparison group (<italic>n</italic> = 123) using generalized linear models. Bootstrapping and other sensitivity analyses were used to incorporate uncertainty in the analyses.</p> </sec> <sec id="jphd12067-sec-0003" sec-type="section"> <title>Results</title> <p>The DM program was associated with a reduction in societal costs of $20 (<italic>p</italic> = 0.85), $215 (<italic>p</italic> = 0.24), and $669 (<italic>p</italic> < 0.01) per patient and a reduction in the number of hospital‐based visits for restorative treatment or extractions by 0.44 (<italic>p</italic> < 0.01), 0.42 (<italic>p</italic> < 0.01), and 0.45 (<italic>p</italic> < 0.01) per patient over 3, 6, and 12 months, respectively. The probability of it being less costly and more effective was 61.5 percent, 81.9 percent, and 98.6 percent over 3, 6, and 12 months, respectively. Consistent results were observed from a health care system and public payer perspectives.</p> </sec> <sec id="jphd12067-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The DM program appears cost‐effective and has the potential to reduce health care costs. Our results justify a multicenter trial to evaluate the DM program on a larger scale.</p> </sec> </abstract>