Cost effectiveness of oral health care program implementation in primary school in Bangkok, Thailand

Abstract

Dental caries are common oral diseases in schoolchildren. This retrospective cohort analysis was done to assess caries prevalence, risk and protective factors associated permanent caries among 433 children profiles of school children in selected primary school in Bangkok who received or did not receive a preventive program. Additionally, a cost effectiveness of the program was analyzed. Result revealed that there was high caries prevalence in deciduous teeth (1st grade) 87.2% and mean dmft 6.44 (± 4.4) and caries prevalence in permanent teeth (6th grade) 51.7% and mean DMFT 1.37 (± 1.84). Risk and protective factors associated permanent caries, after logistic regression analysis found only deciduous caries was a significant risk factor associated with caries in permanent teeth (Adj OR=5.44, 95% of CI = 2.23-13.27). Sealant coverage all 1st molars was a significantly protective factor associated with caries in permanent teeth (Adj OR=0.19, 95% of CI = 0.06-0.63). It indicated that early detection and prevention program should be provided for this group of children.

The total estimated costs of school oral health program (SOHP) in provider perspective, was 1,196,839.37 Baht in economic cost. Salaries of supervisor, costs of equipment and material for sealant, PRR and filling were a majority part of labor costs, capital costs and material costs, respectively. Particularly, in capital cost and material costs were accountable for more than half of total costs. Average capitation of SOHP was equal to 2,045.88 baht per child per year. ICER between completed SOHP and examination group was 2,961.47 baht per DMFT avoided.