Cost-utility analysis of comprehensive dental checks under Teen Dental Plan, Australia

Tonmukayakul, Utsana. (2008). Cost-utility analysis of comprehensive dental checks under Teen Dental Plan, Australia Honours Thesis, School of Economics, The University of Queensland.

       
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Author Tonmukayakul, Utsana.
Thesis Title Cost-utility analysis of comprehensive dental checks under Teen Dental Plan, Australia
School, Centre or Institute School of Economics
Institution The University of Queensland
Publication date 2008
Thesis type Honours Thesis
Total pages 102
Language eng
Subjects 14 Economics
Formatted abstract This study concerns a cost-utility analysis from an Australian health sector perspective of an annual comprehensive dental checks as currently implemented under the 'Teen Dental Plan' recently funded by $360 million to encourage teenagers to have regular dental checks. Under this plan one million kids will get a voucher annually for three consecutive years with which they can claim up to $150 per year for obtaining an oral examination, x-ray, dental clean, scaling, fluoride application and/or pit and fissure sealant from registered dental clinics.

The available evidence on effectiveness of preventive dental checks is sparse and suffers from methodological problems as all but one were observational studies. The only available trial from Norway was conducted over a period of two years as a comparison of annual with biannual checks. It showed a higher caries increment in the teenagers who had checks every other year compared to those who had annual checks, but it was not a statistically significant result. Nevertheless, as this is the best available evidence we decided to model effectiveness based on this trial. We model the impact of the intervention using Australian data on dental caries epidemiology and costs in a decision tree diagram.

The incremental cost-effectiveness ratio (leER) per disability adjusted life year (DALY) is high ranging from $54,000 if the check only includes an oral examination to $220,000 if oral examination, x-ray, and clean are included; and to $620,000 if also scale and sealant are included. Multivariate sensitivity analysis of cost and effectiveness input data suggests that at best there is a 30% probability of a cost effective result if just an oral examination is included. While the evidence is weak the tentative conclusion of this analysis is that dental checks in teenager are not very cost-effective. However, there may be other arguments for the introduction of the Teen Dental Plan such as a wish to provide more equitable access to dental care to teenagers not covered prior to the introduction of the plan.


 
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