Wiedel Anna-Paulina, Norlund Anders, Petrén Sofia, Bondemark Lars
*Department of Oral and Maxillofacial Surgery, Skane University Hospital, Malmö,
**Section of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, and.
Eur J Orthod. 2016 Apr;38(2):140-5. doi: 10.1093/ejo/cjv026. Epub 2015 May 4.
Economic evaluations provide an important basis for allocation of resources and health services planning. The aim of this study was to evaluate and compare the costs of correcting anterior crossbite with functional shift, using fixed or removable appliances (FA or RA) and to relate the costs to the effects, using cost-minimization analysis.
DESIGN, SETTING, AND PARTICIPANTS: Sixty-two patients with anterior crossbite and functional shift were randomized in blocks of 10. Thirty-one patients were randomized to be treated with brackets and arch wire (FA) and 31 with an acrylic plate (RA). Duration of treatment and number and estimated length of appointments and cancellations were registered. Direct costs (premises, staff salaries, material, and laboratory costs) and indirect costs (the accompanying parents' loss of income while absent from work) were calculated and evaluated with reference to successful outcome alone, to successful and unsuccessful outcomes and to re-treatment when required. Societal costs were defined as the sum of direct and indirect costs.
Treatment with FA or RA.
There were no significant differences between FA and RA with respect to direct costs for treatment time, but both indirect costs and direct costs for material were significantly lower for FA. The total societal costs were lower for FA than for RA.
Costs depend on local factors and should not be directly extrapolated to other locations.
The analysis disclosed significant economic benefits for FA over RA. Even when only successful outcomes were assessed, treatment with RA was more expensive.
This trial was not registered.
The protocol was not published before trial commencement.
经济评估为资源分配和卫生服务规划提供重要依据。本研究的目的是评估和比较使用固定矫治器或活动矫治器(FA或RA)纠正伴有功能性移位的前牙反合的成本,并使用成本最小化分析将成本与效果相关联。
设计、地点和参与者:62例伴有功能性移位的前牙反合患者按10例一组进行随机分组。31例患者被随机分配接受方丝弓矫治器(FA)治疗,31例接受丙烯酸板矫治器(RA)治疗。记录治疗持续时间、预约和取消的次数及预计时长。计算并评估直接成本(场地、员工工资、材料和实验室成本)和间接成本(陪同家长误工期间的收入损失),仅参考成功结果、成功和失败结果以及必要时的再治疗情况进行评估。社会成本定义为直接成本和间接成本之和。
使用FA或RA进行治疗。
在治疗时间的直接成本方面,FA和RA之间无显著差异,但FA的间接成本和材料直接成本均显著更低。FA的社会总成本低于RA。
成本取决于当地因素,不应直接外推至其他地区。
分析显示FA相对于RA具有显著的经济效益。即使仅评估成功结果,RA治疗也更昂贵。
本试验未注册。
方案在试验开始前未发表。