The cost‐effectiveness of oral health interventions: A systematic review of cost‐utility analyses

Hettiarachchi, Ruvini; Kularatna, Sanjeewa; Downes, Martin; Byrnes, Joshua; Kroon, Jeroen; Lalloo, Ratilal; Johnson, Newell W.; Scuffham, Paul Anthony

doi:10.1111/cdoe.12336

Cited by 50 publications

(76 citation statements)

References 40 publications

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“…This could reflect the level of resources and expertise required to conduct these studies. Similar findings were reported in a recent systematic review of cost‐utility analysis on oral health interventions for adults and as well as for children, where only two out of 19 studies were conducted in Asian countries 11 …”

Section: Discussionsupporting

confidence: 88%

“…This standard provides 24 items checklist, with accompanying recommendations and examples to ensure more consistence and transparent reporting in Economic evaluations. The CHEERS checklist has been used in published literature in systematic reviews in the fields of economic evaluations assessing healthcare interventions including oral health during the course of this review 11,12 …”

Section: Methodsmentioning

confidence: 99%

“…More recent systematic reviews have focussed on the methods and reporting quality of cost‐effectiveness analyses in oral health. Hettiarachchi et al reported that there was an increasing trend of cost‐utility analyses (CUA) of oral health interventions between 2011 and 2016, with the majority adopting good reporting standards 11 . A 2019 review by Rogers et al examined the scope and quality of economic evaluations in child oral health research and found a limited number of high‐quality economic evaluations in the field of child oral health, due in part to the lack of child‐centred utility measure for paediatric oral health that could be used to quantify Quality Adjusted Life Years (QALYs) 12 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A scoping review of cost‐effectiveness analyses of school‐based interventions for caries

Amilani

Carter

Senanayake

et al. 2020

Comm Dent Oral Epid

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Objectives The aims of this study were to: identify the evidence on cost‐effectiveness of school‐based interventions for caries prevention globally up to 2019; summarize key characteristics of interventions applied within this setting; summarize the reporting quality of previous studies; and to identify and analyse knowledge gaps. Methods A scoping review of published literature on the cost‐effectiveness of school‐based interventions to prevent child tooth decay was conducted. A search in Medline, Cinahl and Embase was performed with no date restriction. Reporting quality of the included studies was assessed against Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results Of the 738 records identified in the initial search, 15 studies met the pre‐specified inclusion criteria. The majority were published after 2011 (n = 9,) and applied to high‐income countries (n = 12). Nearly 80% of the studies assessed the cost‐effectiveness of the interventions based on topical fluoride therapies and fissure sealants at school premises. Although, the outcome measures differed across the studies, almost all the caries preventive interventions were cost‐saving or cost‐effective when compared with usual care. Compliance with the CHEERS checklist differed. Conclusions There is evidence to suggest that school‐based caries preventive interventions are cost‐effective, and in some cases cost‐saving. Further evidence is required from low‐ to middle‐income countries to confirm the generalizability of these findings. Future studies should consider adopting Quality Adjusted Life Years as a generic outcome measure that would enable the cost‐effectiveness findings to be compared across different types of interventions and diseases. Improved standardization and quality of reporting are also required.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A scoping review of cost‐effectiveness analyses of school‐based interventions for caries

Amilani

Carter

Senanayake

et al. 2020

Comm Dent Oral Epid

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“…A questionnaire was used to measure the demographics and oral health of the population at baseline prior to receiving any dental services. A simple cost‐analysis framework was used to analyse the cost associated with set‐up and the dental service value resulting from the treatment provided (Hettiarachchi et al., ; Lalloo & Massey, ; Lalloo et al., ). The post dental appointment questionnaire was designed to measure the participants’ experiences.…”

Section: Methodsmentioning

confidence: 98%

Evaluation of a community based dental clinic for youth experiencing homelessness in Brisbane

Stormon

Pateman

Smith³

et al. 2018

Health Soc Care Community

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The relationship between homelessness and ill health is complex, and many risk factors for homelessness such as unemployment, low income, and substance abuse are also risk factors for poor oral health. In order to overcome barriers to access dental care, previous studies have recommended integrating dental care, referral pathways, and information within the overall care provided by support services available to people at risk of homelessness. This study aimed to evaluate a dental service developed and implemented to improve access to oral health care of disadvantaged youth in Brisbane. A mobile dental clinic run by volunteer dental professionals was implemented into a community organisation for disadvantaged youth. Participants were clients of Brisbane Youth Services who were disadvantaged youth, ≤25 years and attended the dental clinic in a 1 year period. A questionnaire collected demographic information, a self-assessment of oral health and an evaluation of their experiences with the dental clinic. Clinical data including DMFT, appointment attendance and items of service provided were collected. One hundred and twelve clients participated in the four dental clinic weeks and its evaluation. Cost was the greatest reported barrier to accessing dental care among participants. More than half (57%) of participants who pre-booked an appointment failed to attend. A total of 640 services were delivered, with an estimated value of $48,000. The majority (69%, n = 444) of the services provided were preventative services. Almost all of the clients felt the service they received was suitable for them (97%, n = 98) and would use the service again (98%, n = 99). This dental clinic model is feasible and sustainable due to its integration into an existing homeless youth service, low running costs, acceptability to clients and an interest by dental practitioners to volunteer. It provides a useful model which could be scaled up and implemented in other regions.

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“…In the future, information about economic evaluation in dentistry is likely to be required for resource allocation. Despite the above knowledge, economic evaluations are rarely used in dentistry (5)(6)(7). Quality of Life (QoL) assessments have been introduced to support and improve decisions within health care as well as for ethical reasons.…”

mentioning

confidence: 99%

Costs and Health-Related Quality of Life in Relation to Caries

Kastenbom

Falsen

Larsson

et al. 2019

Preprint

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Background Dental caries remains a common and expensive disease for both society and affected individuals. Furthermore, caries often affect individuals’ health-related quality of life (HRQoL). Health economic evaluations are needed to understand how to efficiently distribute dental care resources. This study aims to evaluate treatment costs and QALY weights for caries active and inactive adult individuals, and to test whether the generic instrument EQ-5D-5L can distinguish differences in this population. Methods A total of 1200 randomly selected individuals from dental clinics in Västerbotten County, Sweden, were invited to participate. Of these, 79 caries active and 179 caries inactive patients agreed to participate (response rate of 21.7%). Inclusion criteria were participants between 20-65 years old and same caries risk group categorization in two consecutive check-ups between 2014 and 2017. Results Treatment costs showed to be twice as high in the caries active group compared to the caries inactive group and were three times higher in the caries active age group 20-29 compared to the caries inactive age group 20-29. Differences between the groups was found for number of intact teeth according to age groups. In the EQ-5D-5L instrument, more problems relating to the dimension anxiety/depression was seen in the caries active group. QALY weights showed tendencies (non-significant) to be lower in the caries active group. Conclusions These findings highlight the need for efficient treatments and prevention strategies as well as adequate money allocation within dentistry. However, further research is needed to assess appropriate instruments for health economic evaluations.

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The cost‐effectiveness of oral health interventions: A systematic review of cost‐utility analyses

Cited by 50 publications

References 40 publications

A scoping review of cost‐effectiveness analyses of school‐based interventions for caries

A scoping review of cost‐effectiveness analyses of school‐based interventions for caries

Evaluation of a community based dental clinic for youth experiencing homelessness in Brisbane

Costs and Health-Related Quality of Life in Relation to Caries

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