Sa-Nguanchuea Suthasinee, Tianviwat Sukanya, Thitasomakul Songchai
Department of Dental Public Health, Thapput Hospital, Phang-nga, Thailand.
Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
J Int Soc Prev Community Dent. 2025 Apr 30;15(2):114-125. doi: 10.4103/jispcd.jispcd_147_24. eCollection 2025 Mar-Apr.
To evaluate the cost savings in dental services provided to elderly individuals by comparing primary care units (PCUs) and hospital-based care in Southern Thailand.
A cross-sectional study was conducted involving 322 elderly participants aged 60 years and above. Participants were recruited through multistage sampling from health facilities in three contracted units of primary care (CUPs). Data were collected via structured interviews using validated questionnaires, focusing on total client costs, including treatment, transportation, and opportunity costs. Descriptive and multilevel linear regression analyses were performed using R software, adjusting for key variables such as vehicle type, occupation, and religion.
The mean-adjusted client cost per visit was 59 Baht at PCUs and 176 Baht at hospital settings, yielding a cost-saving of 117 Baht (3.17 USD) per visit. Transportation costs, the largest component, were significantly lower in PCUs (4 Baht) compared to hospitals (72 Baht). Sensitivity analysis over 3 fiscal years (2021-2023) demonstrated consistent cost-savings, with a maximum cumulative saving of 709,937 Baht (19,600 USD) in one CUP. Multilevel linear regression analysis revealed that the type of vehicle and client income significantly influenced total costs. PCUs provided comparable dental services with reduced geographical and economic barriers, enhancing accessibility and affordability for elderly clients.
Delivering dental care at PCUs is a cost-effective alternative to hospital-based care, offering substantial financial benefits and promoting equitable healthcare access for the elderly. Policymakers should consider integrating dental services within primary healthcare frameworks to optimize resource allocation and improve health outcomes in aging populations.
通过比较泰国南部的基层医疗单位（PCU）和医院提供的牙科服务，评估为老年人提供牙科服务的成本节约情况。
开展了一项横断面研究，纳入了322名60岁及以上的老年参与者。通过多阶段抽样从三个基层医疗签约单位（CUP）的卫生机构招募参与者。使用经过验证的问卷通过结构化访谈收集数据，重点关注包括治疗、交通和机会成本在内的总客户成本。使用R软件进行描述性和多水平线性回归分析，并对车辆类型、职业和宗教等关键变量进行调整。
PCU每次就诊的平均调整后客户成本为59泰铢，医院环境下为176泰铢，每次就诊节省成本117泰铢（3.17美元）。交通成本是最大的组成部分，PCU（4泰铢）明显低于医院（72泰铢）。对三个财政年度（2021 - 2023年）的敏感性分析表明成本节约情况一致，一个CUP的最大累计节省为709,937泰铢（19,600美元）。多水平线性回归分析显示，车辆类型和客户收入对总成本有显著影响。PCU提供了可比的牙科服务，减少了地理和经济障碍，提高了老年客户的可及性和可承受性。
在PCU提供牙科护理是一种比医院护理更具成本效益的选择，能带来可观的经济效益，并促进老年人公平获得医疗保健。政策制定者应考虑将牙科服务纳入基层医疗框架，以优化资源配置并改善老年人群的健康结果。
