Kay E, Owen L, Taylor M, Claxton L, Sheppard L
Plymouth University - Peninsula Dental School, Portland Square Drake Circus Plymouth, Devon.
National Institute for Health and Care Excellence - Centre for Public Health, London.
Community Dent Health. 2018 Mar 1;35(1):30-36. doi: 10.1922/CDH_4115Owen07.
Economic evaluations are important tools for decision makers to determine the best allocation of resources in a healthcare system. This study explored the use of economic evaluation in oral health promotion.
A literature review identified oral health promotion programmes that measured both the health impact and costs of oral health interventions. A decision analysis model was constructed to examine the cost utility of preventing dental caries in 5 and 12-year-old children via tooth brushing schemes and fluoride varnish programmes. The costs per child that would be justified according to the National Institute for Health and Care Excellence's threshold of £20,000 per QALY were calculated.
The analysis showed that NICE would consider that the expenditure of £55 per child on supervised tooth brushing, or £100 per child on fluoride varnish application would give sufficient health benefits to be justified according to their threshold.
Greater attention needs to be paid to the collection of robust data on costs for oral health promotion. Dental researchers also urgently need to collect outcome data in a form that can be translated into a Quality of Life measure, so that the true cost effectiveness and value for money achieved through the prevention of dental disease can be recognised and compared to other allocations of resource.
经济评估是决策者在医疗保健系统中确定资源最佳分配的重要工具。本研究探讨了经济评估在口腔健康促进中的应用。
一项文献综述确定了衡量口腔健康干预措施的健康影响和成本的口腔健康促进项目。构建了一个决策分析模型，以研究通过刷牙计划和氟化物涂漆项目预防5岁和12岁儿童龋齿的成本效用。根据英国国家卫生与临床优化研究所（National Institute for Health and Care Excellence）每质量调整生命年20,000英镑的阈值，计算出每个儿童合理的成本。
分析表明，英国国家卫生与临床优化研究所会认为，根据其阈值，每个儿童花费55英镑进行监督刷牙，或花费100英镑进行氟化物涂漆，能带来足够的健康益处，是合理的。
需要更加关注收集关于口腔健康促进成本的可靠数据。牙科研究人员还迫切需要以可转化为生活质量衡量标准的形式收集结果数据，以便能够认识到通过预防牙科疾病所实现的真正成本效益和性价比，并与其他资源分配进行比较。
