Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees.
Arch Pediatr Adolesc Med
; 166(10): 945-51, 2012 Oct.
Article
in En
| MEDLINE
| ID: mdl-22926203
ABSTRACT
OBJECTIVE:
To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB).DESIGN:
Observational study using Medicaid claims data (2000-2006).SETTING:
Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals.PARTICIPANTS:
A total of 209 285 children enrolled in Medicaid at age 6 months.INTERVENTIONS:
Into the Mouths of Babes visits included screening, parental counseling, topical fluoride application, and referral to dentists, if needed. The cost-effectiveness analysis used the Medicaid program perspective and a propensity score-matched sample with regression analysis to compare children with 4 or more vs 0 IMB visits. MAIN OUTCOMEMEASURES:
Dental treatments and Medicaid payments for children up to age 6 years enabled assessment of the likelihood of whether IMB was cost-saving and, if not, the additional payments per hospital episode avoided.RESULTS:
Into the Mouths of Babes is 32% likely to be cost-saving, with discounting of benefits and payments. On average, IMB visits cost $11 more than reduced dental treatment payments per person. The program almost breaks even if future benefits from prevention are not discounted, and it would be cost-saving with certainty if IMB services could be provided at $34 instead of $55 per visit. The program is cost-effective with 95% certainty if Medicaid is willing to pay $2331 per hospital episode avoided.CONCLUSIONS:
Into the Mouths of Babes improves dental health for additional payments that can be weighed against unmeasured hospitalization costs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Preventive Health Services
/
Primary Health Care
/
Medicaid
/
Cost Savings
/
Dental Care for Children
/
Dental Caries
Type of study:
Evaluation_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Implementation_research
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Arch Pediatr Adolesc Med
Journal subject:
PEDIATRIA
Year:
2012
Document type:
Article
Affiliation country:
Estados Unidos