Research associate, Evaluation Platform, George and Fay Yee Centre for Health Care Innovation, University of Manitoba & Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
Senior dental hygienist, SMILEPlus Dental Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
Can J Dent Hyg. 2020 Jun 1;54(2):68-74.
This project compares the cost effectiveness of a preventive fluoride varnish (FV) program with usual dental care (surgery under general anesthesia [GA]) for preschool children in 2 low-income communities in Winnipeg, Canada.
Program impact is described in terms of cost, cavities avoided, and reductions in surgery volume. Aggregate data for 873 children ages 1 to 6 years old enrolled in the Winnipeg Regional Health Authority Daycare Fluoride Varnish Program in January 2018 were analysed using a Markov model.
The program was found to save approximately $822.98 per child over 5 years versus usual dental care. There were 4.38 cavities avoided per child and a savings of $187.71/cavity for the FV group. Participants' need for dental surgery under GA was reduced from 19.1% in the usual care group to 1.6% in the FV group (92% reduction) over 5 years. Sensitivity analyses using a Monte Carlo simulation showed that the program was cost effective over usual care 100% of the time. Finally, it was estimated that the program had saved $753,000 since its inception, or approximately $41.15 per FV application.
The FV intervention had better health outcomes, lower costs, and was less invasive than usual care involving dental surgery under GA for children enrolled in the program.
本项目对比了预防氟化物涂料（FV）方案与常规牙科护理（全麻下手术[GA]）对加拿大温尼伯 2 个低收入社区学龄前儿童的成本效益。
以成本、预防龋齿数量和手术量减少为指标，描述项目的影响。使用马尔可夫模型对 2018 年 1 月参加温尼伯地区卫生局日间护理氟化物涂料项目的 873 名 1 至 6 岁儿童的汇总数据进行分析。
与常规牙科护理相比，该方案在 5 年内可为每个孩子节省约 822.98 加元。FV 组每个孩子可预防 4.38 颗龋齿，每颗龋齿可节省 187.71 加元。FV 组参与者需要全麻下牙科手术的比例从常规护理组的 19.1%降至 5 年内的 1.6%（降低 92%）。使用蒙特卡罗模拟进行的敏感性分析表明，该方案在 100%的情况下均优于常规护理。最后，自项目启动以来，估计已节省 75.3 万加元，或每次 FV 应用约 41.15 加元。
对于参加该项目的儿童，FV 干预措施在健康结果、成本和侵入性方面均优于常规护理下的全麻下手术。
