The costs and consequences of neglected medically necessary oral care

Oral diseases and conditions may adversely affect general health, and certain medical conditions may have a negative effect on oral health. However, little attention has been given to assessing the economic costs and consequences associated with care that is a direct result of, or has a direct impact on, an underlying medical condition and/or its resulting therapy. The costs can be significant for patients; their families; third-party payers such as insurance companies, Medicare, and Medicaid; and society. The health consequences of such conditions may dramatically affect function, morbidity, quality of life, and survival. This paper reviews one possible approach for identifying and measuring the costs and consequences associated with medically necessary oral health care and presents a framework for evaluating medically necessary oral health care. The paper also describes the cost components of care and the dimensions of health consequences. Finally, an example illustrates this approach. The summary information presented here is meant to offer concepts and ideas important in assessing the costs and health consequences associated with medically necessary oral health care. Individuals interested in a more detailed discussion of economic evaluation of health care programs and outcomes assessment are referred elsewhere. 10-23