Molete M P, Chola L, Hofman K J
School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Health Serv Res. 2016 Oct 19;16(1):590. doi: 10.1186/s12913-016-1827-2.
The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale.
In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters.
The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %.
Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.
在南非，大多数儿童未经治疗的龋齿负担仍然很高，口腔医疗保健利用率较低。需要有替代方法来改善获得低成本口腔医疗保健的机会。威特沃特斯兰德大学（Wits）的流动牙科单位已经运营了25年以上，为那些原本无法获得口腔医疗服务的儿童和成人提供替代口腔医疗服务。本研究的目的是对Wits流动牙科单位的一项基于学校的口腔医疗保健项目进行成本分析。目标是估计基于学校的项目的总体成本、每位患者的口腔医疗保健成本以及大规模提供服务的经济影响。
2012年，Wits流动牙科单位开展了一个为期5个月的项目，在约翰内斯堡周边的四所学校提供口腔医疗保健服务。从项目记录中回顾性收集成本和服务使用数据用于成本分析，该分析是从提供者的角度进行的。所考虑的成本包括财务成本和经济成本。资本成本进行了年度化处理，并按6%的贴现率进行贴现。对不确定参数进行了单因素敏感性测试。
总经济成本为813,701兰特（76,048美元）。每位患者的筛查和治疗成本分别为331兰特（31美元）和743兰特（69美元）。此外，在所提供的治疗中，窝沟封闭剂的成本最低。敏感性分析表明，Wits流动牙科单位在工作人员时间分配为25%时具有成本效益，并且由牙科治疗师主导的服务可以节省9.1%的成本。
将服务扩展到更广泛的儿童群体，并将牙科治疗师作为关键人员，可以提高流动牙科医疗服务的效率。
