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Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren

机译:智利学童预防龋齿计划的成本效益模型

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Aim: This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. Methods: Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. Results: Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes 'using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. Conclusion: Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society's financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention.
机译:目的:本研究旨在从社会角度评估智利学龄儿童中的七个龋齿预防计划的成本效益:三个社区计划:水氟化,盐氟化和牙科密封剂;以及四个基于学校的计划:牛奶加氟;氟化漱口水(FMR); APF凝胶,以及含氟牙膏的监督性牙刷。方法:采用标准的成本效益分析方法。从社会角度出发,确定并估算了与实施和实施每个计划相关的成本。比较者没有干预。通过6年内避免龋齿来衡量健康结局。成本被估计为直接治疗成本,计划成本以及由于每个龋齿预防计划而导致的生产力损失成本。计算了每个计划的成本效益比增量。对关键参数进行了敏感性分析。结果:初步成本效益分析(折现)表明,有四个计划显示DMFT避免了社会净储蓄。这些节省包括每个患病牙齿的价值范围。 16.21美元(盐氟化),14.89美元(社区水氟化); 14.78美元(牛奶加氟);和$ 8.63(FMR)。 “使用APF-Gel应用,牙科密封剂和使用氟化牙膏的有监督刷牙”的个别计划分别表示,每颗患病牙齿避免的社会成本分别为21.30美元,11.56美元和8.55美元。结论:根据预防小学生中一颗龋齿所需的成本,盐氟化是最具成本效益的,而APF-Gel成本效益最低。研究结果证实,大多数基于社区/学校的龋齿干预措施都是对社会财务资源的经济有效利用。使用的模型是保守的,可能会低估每次干预的实际收益。

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