Economic Evaluation of a Pilot School-Based Dental Checkup Program.

Area of Science:

• Public Health
• Health Economics
• Pediatric Dentistry

Background:

• Dental caries remains a significant public health issue, particularly in low socioeconomic status populations.
• Existing standard dental care models may not effectively reach or serve all children, especially those in underserved communities.
• Economic evaluations are crucial for assessing the value and sustainability of public health interventions.

Purpose of the Study:

• To conduct an economic evaluation of a targeted, school-based dental checkup program in northern metropolitan Melbourne.
• To compare the cost-utility and cost-effectiveness of a pilot outreach intervention versus passive standard dental care.
• To assess the program's impact on reaching underserved populations, defined by government concession eligibility.

Main Methods:

• A 12-month retrospective case-control cohort analysis using a decision tree model.
• Societal perspective adopted, including health sector costs, patient/family costs, and productivity losses.
• Outcome measures included quality-adjusted tooth years (QATY) and decayed, missing, and filled teeth prevented (DMFT-prevented).

Main Results:

• The intervention group incurred lower total societal costs ($291/child) compared to standard care ($463/child), with a cost saving of $172 per child.
• The outreach program reached a higher proportion of eligible children (66.2%) compared to standard care (50.0%).
• The incremental cost-effectiveness ratio (ICER) was $3,252 per DMFT-prevented, and the intervention dominated standard care for QATY and reach.

Conclusions:

• The pilot school-based dental checkup program was less costly and more effective than standard care, particularly for reaching underserved children.
• The findings provide fiscal economic evidence supporting the expansion of similar outreach programs to reduce dental caries in low-income families.
• Further research is recommended to quantify the long-term value of outreach interventions in preventing and managing dental caries in vulnerable populations.