Projecting the economic impact of silver diamine fluoride on caries treatment expenditures and outcomes in young US children
Projecting the economic impact of silver diamine fluoride on caries treatment expenditures and outcomes in young US children
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DOI：
10.1111/jphd.12312
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发表时间：
2019-09-01
影响因子：
2.3
通讯作者：
Tomar, Scott L.
中科院分区：
文献类型：
--
作者：
Johhnson, Ben;Serban, Nicoleta;Tomar, Scott L.
目的从医疗补助计划的角度，量化使用银二胺氟化物（SDF）阻止1-5岁儿童龋齿进展相对于标准修复治疗的经济影响。方法我们使用蒙特卡罗模拟来估计不同SDF有效性和干预渗透水平的避免恢复性访问和相关支出。我们比较了目前治疗龋齿的护理标准和应用SDF。我们从2010-2012年美国七个州的医疗补助分析摘要文件中估计了支出，并估计了SDF应用于避免恢复性访视的增量成本效益比。结果在七个州，避免恢复访问范围从2,049（佛蒙特州）到60,542（北卡罗来纳州），假设SDF渗透率为50%。避免每次恢复性访问的成本从100美元到350美元不等。有较高的避免每次恢复性访问成本在非大都市县比大都市县。结论提供SDF作为龋齿管理策略可以通过避免昂贵的龋齿治疗方案来减少医疗补助计划的牙科护理支出。它还可以防止压力恢复程序。州医疗补助计划应考虑偿还SDF，以阻止幼儿龋齿的进展。
Objective To quantify the economic impact of using silver diamine fluoride (SDF) to arrest the progression of dental caries in Medicaid-enrolled children (aged 1-5 years) relative to the standard restorative treatment from the Medicaid programs' perspective. Methods We used Monte Carlo simulation to estimate averted restorative visits and associated expenditures for varying SDF effectiveness and intervention penetration levels. We compared the current standard of care for treating caries to applying SDF. We estimated expenditures from the 2010-2012 Medicaid Analytic Extract files for seven US states and the incremental cost effectiveness ratio for SDF application on averted restorative visits. Results Across the seven states, averted restorative visits ranged from 2,049 (Vermont) to 60,542 (North Carolina), assuming an SDF penetration level of 50%. Averted per-restorative visit costs ranged from $100 to $350 per-visit. There were higher averted per-restorative visit costs in nonmetropolitan counties than metropolitan counties. Conclusions Providing SDF as a caries management strategy can reduce Medicaid program dental care expenditures by averting expensive caries treatment options. It could also prevent stressful restorative procedures. State Medicaid programs should consider reimbursing for SDF to arrest the progression of dental caries in young children.