Department of Dental Hygiene, Daejeon Institute of Science and Technology, Daejeon, Republic of Korea.
Department of Dental Hygiene, Wonkwang Health Science University, North Jula, Republic of Korea.
PLoS One. 2022 Jun 13;17(6):e0269770. doi: 10.1371/journal.pone.0269770. eCollection 2022.
The aims of this study are to evaluate the cost-effectiveness of early dental visits (EDVs) and to investigate how regional deprivation impacts the economic evaluation.
This study used the South Korea National Health Insurance database, which included medical claim data and voluntary-based oral examination data. The subjects of this study included whole participants for oral examinations for infants and toddlers of the National Health Insurance Corporation. A retrospective cohort study was designed and measured all oral treatments, costs, and number of visits for 208,969 children (experimental group, 101,768; non- experimental group, 107,201) who underwent oral examination for infants and toddlers from 2007 to 2014. The cost-effectiveness was measured using the incremental cost-effectiveness ratio, and the T-health index was used as the measurement for effectiveness. In addition, the difference in the effect according to the level of regional deprivation was confirmed.
The findings of this study showed that EDVs were cost-effective and that children who participated in EDVs had better oral health (T-health-2 index difference 0.32 point in most deprived regions) and needed 5 USD less costly dental treatments than those who did not have EDVs. The cost-effectiveness of EDVs varied according to the level of regional deprivation and was the highest in the most deprived regions.
The study findings suggested that the provision of oral examination for infants and toddlers was a cost-effective dental policy. Additionally, EDVs were more effective in children who resided in the most deprived regions, a finding that will lead to the development of policy intervention to improve dental care despite spatial inequality for disadvantaged population groups. Regarding the distribution of dental hospitals/clinics, incentive based dental polices for either dental providers or patients are needed that will assure the delivery of dental care despite spatial inequality.
本研究旨在评估早期牙科就诊(EDV)的成本效益,并探讨区域贫困对经济评估的影响。
本研究使用了韩国国家健康保险数据库,其中包括医疗索赔数据和自愿口腔检查数据。本研究的对象包括韩国国民健康保险公司对婴幼儿进行口腔检查的所有参与者。设计了一项回顾性队列研究,对 208969 名儿童(实验组 101768 名,非实验组 107201 名)的所有口腔治疗、成本和就诊次数进行了测量,这些儿童在 2007 年至 2014 年间接受了婴幼儿口腔检查。采用增量成本效益比衡量成本效益,采用 T-健康指数衡量效果。此外,还确认了根据区域贫困程度的差异对效果的影响。
本研究结果表明,EDV 具有成本效益,且接受 EDV 的儿童口腔健康状况更好(最贫困地区 T-健康-2 指数差异为 0.32 分),且需要的牙科治疗费用比未接受 EDV 的儿童低 5 美元。EDV 的成本效益因区域贫困程度而异,在最贫困地区最高。
研究结果表明,为婴幼儿提供口腔检查是一项具有成本效益的牙科政策。此外,在最贫困地区的儿童中,EDV 的效果更为显著,这一发现将促使制定政策干预措施,以改善牙科保健,尽管弱势群体存在空间不平等。关于牙科医院/诊所的分布,需要制定基于激励的牙科政策,无论是针对牙科提供者还是患者,以确保在存在空间不平等的情况下提供牙科保健。