Murata Tatsunori, Arai Korenori, Kashiwagi Kosuke, Baba Shunsuke
Department of Oral Implantology, Osaka Dental University, Hirakata Japan.
Department of Fixed Prosthodontics and Occlusion, Osaka Dental University, Hirakata Japan.
J Health Econ Outcomes Res. 2020 Jan 24;7(1):1-9. doi: 10.36469/001c.11594. eCollection 2020.
There are several previous reports suggesting that the number of remaining teeth is related to increase of total medical expenditure. However, the measurements of oral healthcare conditions used in the previous studies were the number of remaining teeth, and occlusal support was not assessed.
The aim of this study was to evaluate the relationships between occlusal support and healthcare resource utilization.
This study was a retrospective cohort study using a claims database. Measurements of occlusal support were defined by the Eichner and Miyachi classification systems based on dental formula information. Medical healthcare resource usage was measured by medical visit rate and 12-month medical expenditure.
Of the total population in the claims database, 1 288 713 patients were included in the analysis. The proportion of patients who had at least one medical visit and annual medical expenditure in the best condition classes in each classification measure (i.e. A1 for Eichner classification and Area I for Miyachi classification in both endpoints) were 58.2% and 61.1%, and JPY34 597 (US$314.52 at JPY110/US$) and JPY43 129 (US$392.08), respectively. Those in the poorest condition classes in each classification measure (i.e. B3 for Eichner classification and Area IV for Miyachi classification in the medical visit rate, and C1 for Eichner classification and Area III for Miyachi classification in medical expenditure) were 75.3% and 75.1%, and JPY149 339 (US$1357.63) and JPY120 925 (US$1099.32), respectively. We found a positive correlation with the outcomes by regression analysis adjusting for deterioration of occlusal support with age and gender.
We found significant relationships between occlusal support conditions and healthcare resource utilization. The maintenance of oral health or dental treatment may positively impact overall health, and active dental intervention may reduce the total medical expenditure.
先前有几份报告表明,留存牙齿的数量与医疗总支出的增加有关。然而,先前研究中使用的口腔保健状况衡量指标是留存牙齿的数量,并未评估咬合支持情况。
本研究旨在评估咬合支持与医疗资源利用之间的关系。
本研究是一项使用索赔数据库的回顾性队列研究。咬合支持的衡量指标是基于牙列信息,由艾希纳(Eichner)分类系统和宫地(Miyachi)分类系统定义的。医疗资源使用情况通过就诊率和12个月的医疗支出进行衡量。
索赔数据库中的总人口中,有1288713名患者纳入分析。在每种分类指标中处于最佳状况等级的患者(即艾希纳分类中的A1级以及两个终点指标中宫地分类的I区),至少就诊一次的患者比例和年度医疗支出分别为58.2%和61.1%,以及34597日元(按110日元兑换1美元计算为314.52美元)和43129日元(392.08美元)。在每种分类指标中处于最差状况等级的患者(即就诊率方面艾希纳分类中的B3级和宫地分类中的IV区,以及医疗支出方面艾希纳分类中的C1级和宫地分类中的III区),分别为75.3%和75.1%,以及149339日元(1357.63美元)和120925日元(1099.32美元)。通过对年龄和性别导致的咬合支持恶化进行调整的回归分析,我们发现结果呈正相关。
我们发现咬合支持状况与医疗资源利用之间存在显著关系。保持口腔健康或进行牙科治疗可能对整体健康产生积极影响,积极的牙科干预可能会降低医疗总支出。