在统一卫生系统中使用的不同牙髓器械技术的经济分析。

Economic analysis of the different endodontic instrumentation techniques used in the Unified Health System.

机构信息

Department of Public Health, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil.

Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil.

出版信息

BMC Oral Health. 2022 Aug 11;22(1):344. doi: 10.1186/s12903-022-02369-x.

DOI:10.1186/s12903-022-02369-x

PMID:35953805

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9373286/

Abstract

BACKGROUND

To assess the financial impact of incorporating a new (reciprocal) technology into endodontic treatments in the public health system (SUS).

METHODS

This was a economic evaluation study (comparing the 3 different endodontic instrumentation techniques-manual, rotary and reciprocating), allocative efficiency analysis to optimize existing resources in the SUS, and financial contribution impact analysis of incorporation of a new technology. Thirty-one (31) 12 years-old volunteers were evaluated.

RESULTS

The incremental cost-effectiveness ratio (ICER) was calculated at R$1.34/min, - R$0.60/min and BRL 0.10/min for the single-rooted, bi-rooted and tri-rooted teeth, respectively, when the rotary technique was compared with the manual type. In turn, the ICER was R$ 21.04/min, - R$ 0.73/min and - R$ 2.81/min for the 3 types of teeth, respectively, when the reciprocating technique was compared with the manual type. The incremental financial impact of replacing manual endodontic with rotary endodontic treatments would be - R$ 2060963.66 in the case of single-rooted teeth, but the number of treatments would also be reduced (- 19,379). In the case of two-rooted teeth, the incremental financial impact would be BRL 34921540.62 with the possibility of performing an additional 204,110 treatments. In turn, BRL 11523561.50 represented the incremental financial impact for teeth with 3 or more roots and with an increase of 72,545 procedures. When we analyzed the incremental financial impact of replacing manual endodontic with reciprocating endodontic treatments, it would be - R$ 730227.80 in the case of single-rooted teeth, allowing for an additional 2538 treatments. In turn, R$ 21674853.00 represented the incremental financial impact for bi-radicular teeth, with an increase of 121,700 procedures. In the case of two-rooted teeth, the incremental financial impact would be BRL 13591742.90 with the possibility of performing an additional 40,670 treatments.

CONCLUSIONS

The reciprocating technique could improve access to endodontic treatment in the SUS as it allowed a simultaneous reduction in clinical time and associated costs. However, the higher number of endodontic treatments performed would have a financial impact.

摘要

背景

评估在公共卫生系统（SUS）中纳入新（互惠）技术对牙髓治疗的财务影响。

方法

这是一项经济评估研究（比较手动、旋转和往复三种不同的牙髓仪器技术），分配效率分析以优化 SUS 中的现有资源，以及新技术纳入的财务贡献影响分析。对 31 名 12 岁志愿者进行了评估。

结果

与手动类型相比，当旋转技术与手动类型相比时，单根、双根和三根牙齿的增量成本效益比（ICER）分别计算为 R$1.34/min，-R$0.60/min 和 BRL 0.10/min。相比之下，当往复技术与手动类型相比时，三种类型牙齿的 ICER 分别为 R$21.04/min，-R$0.73/min 和-R$2.81/min。如果用旋转牙髓治疗取代手动牙髓治疗，单根牙齿的增量财务影响将为-R$2060963.66，但治疗次数也会减少（-19379）。对于双根牙齿，增量财务影响将为 BRL 34921540.62，同时可以进行额外的 204110 次治疗。反过来，BRL 11523561.50 代表具有 3 个或更多根的牙齿的增量财务影响，同时增加了 72545 个程序。当我们分析用往复式牙髓治疗取代手动牙髓治疗的增量财务影响时，单根牙齿的影响为-R$730227.80，可以增加 2538 次治疗。反过来，BRL 21674853.00 代表双根牙齿的增量财务影响，同时增加了 121700 次治疗。对于双根牙齿，增量财务影响将为 BRL 13591742.90，可以进行额外的 40670 次治疗。