新西兰水氟化的成本与收益。
The costs and benefits of water fluoridation in NZ.
机构信息
Sapere Research Group Limited, PO Box 587, Wellington, New Zealand.
Sir John Walsh Research Institute, School of Dentistry, The University of Otago, PO Box 56, Dunedin, New Zealand.
出版信息
BMC Oral Health. 2017 Nov 28;17(1):134. doi: 10.1186/s12903-017-0433-y.
BACKGROUND
Implementing community water fluoridation involves costs, but these need to be considered against the likely benefits. We aimed to assess the cost-benefit and cost-effectiveness of water fluoridation in New Zealand (NZ) in terms of expenditure and quality-adjusted life years.
METHODS
Based on published studies, we determined the risk reduction effects of fluoridation, we quantified its health benefits using standardised dental indexes, and we calculated financial savings from averted treatment. We analysed NZ water supplies to estimate the financial costs of fluoridation. We devised a method to represent dental caries experience in quality-adjusted life years.
RESULTS
Over 20 years, the net discounted saving from adding fluoride to reticulated water supplies supplying populations over 500 would be NZ$1401 million, a nine times pay-off. Between 8800 and 13,700 quality-adjusted life years would be gained. While fluoridating reticulated water supplies for large communities is cost-effective, it is unlikely to be so with populations smaller than 500.
CONCLUSIONS
Community water fluoridation remains highly cost-effective for all but very small communities. The health benefits-while (on average) small per person-add up to a substantial reduction in the national disease burden across all ethnic and socioeconomic groups.
背景
实施社区水氟化需要成本，但需要将这些成本与可能的收益进行权衡。我们旨在评估新西兰（NZ）水氟化在支出和质量调整生命年方面的成本效益和成本效益。
方法
根据已发表的研究，我们确定了氟化的风险降低效果，使用标准化的牙科指标量化了其健康益处，并计算了避免治疗的财务节省。我们分析了新西兰的供水系统，以估算氟化的财务成本。我们设计了一种方法来代表质量调整生命年中的龋齿经历。
结果
在 20 多年的时间里，向供应超过 500 人的管网水供应中添加氟化物的净折扣节省将达到 1.401 亿新西兰元，是九倍的回报。将获得 8800 至 13700 个质量调整生命年。虽然为大型社区的管网水氟化是具有成本效益的，但对于人口少于 500 的社区，这种情况不太可能。
结论
除了非常小的社区外，社区水氟化仍然具有很高的成本效益。健康益处虽然（平均而言）每个人的益处很小，但加起来会大大减轻所有族裔和社会经济群体的国家疾病负担。
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