Dyson Kate, Kruger Estie, Tennant Marc
Centre for Rural and Remote Oral Health, The University of Western Australia, Nedlands, Western Australia, Australia.
Aust J Rural Health. 2012 Dec;20(6):334-8. doi: 10.1111/j.1440-1584.2012.01318.x.
This study examines the cost effectiveness of a model of remote area oral health service.
Retrospective financial analysis.
Rural and remote primary health services.
Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study.
Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision.
The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care.
本研究考察一种偏远地区口腔健康服务模式的成本效益。
回顾性财务分析。
农村和偏远地区的初级卫生服务机构。
农村和偏远地区口腔健康中心提供联网上门口腔健康服务的临床活动数据及相关成本数据构成了研究数据框架的基础。本研究考察了该中心在2006年、2008年和2010年西澳大利亚州五个农村和偏远地区的服务提供模式的成本效益。
利用数据记录和牙医牙科服务收费表计算服务提供成本和所提供护理的价值。确定每个地点的服务提供成本与所提供护理价值的比率,并与适用于大规模政府部门服务提供模式的同等比率进行对比。
联网模式在其他学科中已被证明有效,但本研究首次表明,一种由一个中心和五个分支组成的联网中心辐射模式在偏远地区口腔医疗保健中具有成本效益。通过排除该中心引入的特殊成本节约举措,本研究在澳大利亚一些最具挑战性的地区,考察了易于转化的直接服务提供成本与直接临床护理结果之间的关系。本研究发现,联网中心辐射式护理模式在偏远地区口腔医疗保健中可能是具有财务效益的安排。