Griffin S O, Gooch B F, Beltrán E, Sutherland J N, Barsley R
Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations and Research Branch, Chamblee, GA 30341, USA.
J Public Health Dent. 2000 Winter;60(1):21-7. doi: 10.1111/j.1752-7325.2000.tb03287.x.
This study compared types and costs of dental services rendered to children who had received care in a hospital operating room (H) with children who had not (NH).
The study population consisted of all children aged 1-5 years who received a dental service reimbursed by the Louisiana Medicaid EPSDT program from October 1996 through September 1997. Claim files were provided by the Louisiana Bureau of Health Services Financing. A treatment intensity index [TII = 3 x (# extractions) + 2 x (# pulpotomies + # crowns) + # simple restorations] was calculated for H children (n = 2, 142) and NH children (n = 38,423). Using logistic regression, a dichotomous hospitalization variable (H vs NH) was regressed against treatment intensity and selected personal and parish (county) characteristics for each of the five age groups. Total and average reimbursement per child were calculated for both groups of children, by age.
The mean treatment intensity scores for H and NH children were 24.02 (SD = 11.82) and 2.16 (SD = 4.78), respectively. For all age groups, children with treatment intensity scores greater than 8 were at least 132 times more likely to be hospitalized than were children with scores less than or equal to 8. The mean cost for care provided to H children was $1,508 compared with $104 for NH. Total costs for dental care rendered to H children (5% of the study population) were $3,229,851 (45% of total dental costs for the study population).
Reducing severe caries through early interventions could provide substantial cost savings.
本研究比较了在医院手术室接受治疗的儿童（H组）和未在医院手术室接受治疗的儿童（非H组）所接受的牙科服务类型及费用。
研究对象为1996年10月至1997年9月期间接受路易斯安那州医疗补助计划（EPSDT）报销的牙科服务的所有1至5岁儿童。索赔文件由路易斯安那州卫生服务融资局提供。计算了H组儿童（n = 2142）和非H组儿童（n = 38423）的治疗强度指数[TII = 3×（拔牙数量）+ 2×（牙髓切断术数量 + 牙冠修复数量）+ 简单修复数量]。使用逻辑回归分析，将二分住院变量（H组与非H组）与五个年龄组中每个年龄组的治疗强度以及选定的个人和教区（县）特征进行回归分析。按年龄计算了两组儿童的每位儿童的总报销费用和平均报销费用。
H组和非H组儿童的平均治疗强度得分分别为24.02（标准差 = 11.82）和2.16（标准差 = 4.78）。对于所有年龄组，治疗强度得分大于8的儿童住院的可能性至少是非H组儿童的132倍。H组儿童的护理平均费用为1508美元，而非H组为104美元。H组儿童（占研究人群的5%）的牙科护理总费用为3229851美元（占研究人群牙科总费用的45%）。
通过早期干预减少严重龋齿可大幅节省成本。
