Oral Health Services, Health Centre of Pori, Finland.
Eur J Orthod. 2013 Feb;35(1):22-8. doi: 10.1093/ejo/cjr053. Epub 2011 Jul 10.
The objectives of the study were to compare the costs and outcome of orthodontic treatment in eight municipal health centres in Finland. A random sample of the age groups of 16- and 18-year-olds (n = 1109) living in these municipalities was clinically examined by two calibrated orthodontists. The acceptability of the morphology and function of the occlusion were assessed with the Occlusal Morphology and Function Index (OMFI). The data concerning previous orthodontic treatment were collected from the patient records of all subjects (n = 608) who reported previous or ongoing orthodontic treatment or who could not recall if they had received orthodontic treatment. The health centres were grouped into an early and a late timing group according to the mean age of starting the treatment. The mean age for starting orthodontic treatment was 8.0 years (SD 1.9) in the early group and 10.7 years (SD 2.3) in the late group. The visit costs and the costs of orthodontic appliances without overheads comprised the operating costs. The cost-effectiveness of orthodontic services was measured by estimating how much each health centre had to have paid for one per cent unit of acceptable morphology and acceptable function of occlusion. The mean appliance costs were higher in the late timing group and the mean visit costs higher in the early timing group. The mean operating costs per case were €720 in the early and €649 in the late timing group. However, there was a great variation within both groups. The cost of one per cent unit of acceptable morphology was the same in the two timing groups, while the cost of one per cent unit of acceptable function was lower in the early timing group. The low operating costs as such did not totally explain the better cost-effectiveness of orthodontic care. Furthermore, the cost-effectiveness was not directly connected with the timing of treatment.
本研究的目的是比较芬兰 8 家市立健康中心的正畸治疗成本和结果。通过两位经过校准的正畸医生对居住在这些市的 16 岁和 18 岁年龄组的随机样本进行临床检查。使用咬合形态和功能指数（Occlusal Morphology and Function Index，OMFI）评估咬合形态和功能的可接受性。通过收集所有报告过去或正在接受正畸治疗或无法回忆是否接受过正畸治疗的患者（n=608）的病历数据，获得关于既往正畸治疗的数据。根据治疗开始的平均年龄，将健康中心分为早期和晚期治疗组。早期组开始正畸治疗的平均年龄为 8.0 岁（SD=1.9），晚期组为 10.7 岁（SD=2.3）。就诊费用和不包括间接费用的正畸器械费用构成了运营成本。通过估计每个健康中心需要支付多少费用才能获得 1%可接受的咬合形态和功能的单位来衡量正畸服务的成本效益。晚期治疗组的平均器械费用较高，早期治疗组的平均就诊费用较高。早期治疗组的每个病例平均运营成本为 720 欧元，晚期治疗组为 649 欧元。然而，两个组内都存在很大的差异。两组的 1%可接受形态单位的成本相同，而 1%可接受功能单位的成本在早期治疗组中较低。如此低的运营成本并不能完全解释正畸治疗成本效益的提高。此外，成本效益与治疗时间并无直接关系。
