Demonstration of high value care to improve oral health of a remote Indigenous community in Australia
Abstract Background The oral health of Indigenous children in remote communities is much worse than other population groups in Australia. Providing and maintaining an oral health service is challenging due to the remoteness of communities, the associated high cost, and the low retention of clinical...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-02-01
|
Series: | Health and Quality of Life Outcomes |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12955-020-01300-8 |
id |
doaj-00afaafd2965401896dfb4b8ffd302ea |
---|---|
record_format |
Article |
spelling |
doaj-00afaafd2965401896dfb4b8ffd302ea2020-11-25T02:06:29ZengBMCHealth and Quality of Life Outcomes1477-75252020-02-0118111010.1186/s12955-020-01300-8Demonstration of high value care to improve oral health of a remote Indigenous community in AustraliaSanjeewa Kularatna0Ratilal Lalloo1Jeroen Kroon2Santosh K. K. Tadakamadla3Paul A. Scuffham4Newell W. Johnson5Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of TechnologySchool of Dentistry, The University of QueenslandSchool of Dentistry and Oral Health, Giffith UniversitySchool of Dentistry and Oral Health, Giffith UniversityMenzies Health Institute Queensland, Griffith UniversitySchool of Dentistry and Oral Health, Giffith UniversityAbstract Background The oral health of Indigenous children in remote communities is much worse than other population groups in Australia. Providing and maintaining an oral health service is challenging due to the remoteness of communities, the associated high cost, and the low retention of clinical staff. An annual preventive intervention delivered by fly-in clinicians may be a more cost-effective way to manage this problem. In this analysis we estimate the cost-effectiveness of an annual professional intervention for the prevention of dental caries in children of a remote Indigenous community in Far North Queensland. Methods A cost-effectiveness analysis was conducted based on an annual preventive intervention protocol. This included treating all dental decay in those with disease, applying fissure sealants, a disinfectant swab, fluoride varnish and providing oral hygiene instructions and dietary advice to all participating school children. This study included an intervention group and a natural comparison group and both groups were followed-up for 2 years after the initial preventive intervention. A Markov model was built to assess the cost-effectiveness of the intervention compared with the usual care. Costs of treatment from the Queensland Department of Health were used and effectiveness was measured as quality-adjusted life years (QALYs) with the CHU-9D. One-way and probabilistic sensitivity analyses were conducted to identify key drivers and quantify uncertainty. Results The preventive intervention was found to be highly cost-effective. The incremental cost per QALY gained was AU$3747. Probability of new caries and seeking treatment were identified as the main drivers of the model. In probabilistic sensitivity analysis intervention was cost effective in 100% of simulations. Conclusion An annual preventive intervention for remote Indigenous communities in Australia is a highly cost-effective strategy to prevent dental caries and improve the quality of life of children.http://link.springer.com/article/10.1186/s12955-020-01300-8Cost effectivenessOral healthIndigenousUtilityCost utilityQALY |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sanjeewa Kularatna Ratilal Lalloo Jeroen Kroon Santosh K. K. Tadakamadla Paul A. Scuffham Newell W. Johnson |
spellingShingle |
Sanjeewa Kularatna Ratilal Lalloo Jeroen Kroon Santosh K. K. Tadakamadla Paul A. Scuffham Newell W. Johnson Demonstration of high value care to improve oral health of a remote Indigenous community in Australia Health and Quality of Life Outcomes Cost effectiveness Oral health Indigenous Utility Cost utility QALY |
author_facet |
Sanjeewa Kularatna Ratilal Lalloo Jeroen Kroon Santosh K. K. Tadakamadla Paul A. Scuffham Newell W. Johnson |
author_sort |
Sanjeewa Kularatna |
title |
Demonstration of high value care to improve oral health of a remote Indigenous community in Australia |
title_short |
Demonstration of high value care to improve oral health of a remote Indigenous community in Australia |
title_full |
Demonstration of high value care to improve oral health of a remote Indigenous community in Australia |
title_fullStr |
Demonstration of high value care to improve oral health of a remote Indigenous community in Australia |
title_full_unstemmed |
Demonstration of high value care to improve oral health of a remote Indigenous community in Australia |
title_sort |
demonstration of high value care to improve oral health of a remote indigenous community in australia |
publisher |
BMC |
series |
Health and Quality of Life Outcomes |
issn |
1477-7525 |
publishDate |
2020-02-01 |
description |
Abstract Background The oral health of Indigenous children in remote communities is much worse than other population groups in Australia. Providing and maintaining an oral health service is challenging due to the remoteness of communities, the associated high cost, and the low retention of clinical staff. An annual preventive intervention delivered by fly-in clinicians may be a more cost-effective way to manage this problem. In this analysis we estimate the cost-effectiveness of an annual professional intervention for the prevention of dental caries in children of a remote Indigenous community in Far North Queensland. Methods A cost-effectiveness analysis was conducted based on an annual preventive intervention protocol. This included treating all dental decay in those with disease, applying fissure sealants, a disinfectant swab, fluoride varnish and providing oral hygiene instructions and dietary advice to all participating school children. This study included an intervention group and a natural comparison group and both groups were followed-up for 2 years after the initial preventive intervention. A Markov model was built to assess the cost-effectiveness of the intervention compared with the usual care. Costs of treatment from the Queensland Department of Health were used and effectiveness was measured as quality-adjusted life years (QALYs) with the CHU-9D. One-way and probabilistic sensitivity analyses were conducted to identify key drivers and quantify uncertainty. Results The preventive intervention was found to be highly cost-effective. The incremental cost per QALY gained was AU$3747. Probability of new caries and seeking treatment were identified as the main drivers of the model. In probabilistic sensitivity analysis intervention was cost effective in 100% of simulations. Conclusion An annual preventive intervention for remote Indigenous communities in Australia is a highly cost-effective strategy to prevent dental caries and improve the quality of life of children. |
topic |
Cost effectiveness Oral health Indigenous Utility Cost utility QALY |
url |
http://link.springer.com/article/10.1186/s12955-020-01300-8 |
work_keys_str_mv |
AT sanjeewakularatna demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia AT ratilallalloo demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia AT jeroenkroon demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia AT santoshkktadakamadla demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia AT paulascuffham demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia AT newellwjohnson demonstrationofhighvaluecaretoimproveoralhealthofaremoteindigenouscommunityinaustralia |
_version_ |
1724933689968689152 |