Economic Evaluation of School-Based Caries Prevention Programs

摘要该项目的主要目标是通过以下方式改善口腔保健服务并减少健康不平等现象 进行强有力的经济评估，以支持决策者和利益攸关方的决策。至 为了实现这一目标，拟议的研究有三个主要目标，即评估变化如何 以学校为基础的龋病预防计划(SCPP)的计划设计和先前使用牙科保健的影响(1) 口腔健康结果，(2)医疗补助的使用和支出，以及(3)总体成本效益和预算 SCPP的影响。这将使用一种新的数据链接来实现，该数据链接来自 两个多点SCPP和纽约医疗补助索赔数据的务实临床试验。之前的系统审查 SCPP在SCPP计划的设计和实施中发现了显著的差异。因此， 建议的研究对于确定现实世界环境中具有成本效益的SCPP计划设计至关重要。 为了支持这项研究，舒拉米特·S·黄博士正在申请K-25奖项。黄医生，一个健康的人 纽约大学牙科学院专门研究牙科市场的经济学家 在牙科干预和口腔健康的经济评估中确立自己作为年轻研究员的地位 服务研究。这一奖项将使黄医生能够将她的背景和健康经验结合起来 经济学和政策评估，以及临床研究方法和临床评估方面的额外培训 采取干预措施，努力缩小健康差距，改善保健服务的提供和质量。 在目标1中，黄博士将在考虑了以下因素后，确定SCPP对口腔健康结果的影响 以前使用过牙科护理。作为这一目标的一部分，黄博士将把一家务实的临床诊所的口腔健康结果数据联系起来 将两种不同的SCPP计划设计与纽约医疗补助/芯片索赔数据进行个人比较的试验 水平。在目标2中，黄博士将评估SCPPS对牙科保健的使用和支出的影响 参加医疗补助/CHIP的儿童的条件。在目标3中，黄博士将评估成本效益和 不同SCPP方案设计相对于非SCPP方案的预算影响。这项研究将启动Dr。 黄在口腔健康服务研究方面的职业生涯，旨在将数学建模与大型 数据集分析，以研究牙科护理服务和支付方式的变化对大量人口的影响。 这项工作将在K奖完成之前以R01赠款申请的形式进行。 黄博士组建了一个指导团队，由主要导师希瑟·戈尔德博士和 人口健康研究和临床和行为干预的经济评估专家 纽约大学朗格尼健康和医学院副教授；以及一位共同导师理查德博士 Niederman，牙医，流行病学和健康促进系教授兼主任 纽约大学牙科学院进行的SCPP实用临床试验为本研究提供了数据。

Abstract The primary goal of this project is to improve oral health care delivery and reduce health inequities by conducting robust economic evaluations to support decision-making by policymakers and stakeholders. To achieve this goal, the proposed study has three primary objectives, which are to evaluate how variation in program design of school-based caries prevention programs (SCPPs) and prior use of dental care impacts (1) oral health outcomes, (2) use and spending within Medicaid, and (3) the overall cost-effectiveness and budget impact of SCPPs. This will be done using a novel data linkage between oral health outcomes data from a pragmatic clinical trial of two multi-site SCPPs and New York Medicaid claims data. Prior systematic reviews of SCPPs have found significant variation in SCPP program design and implementation. As a result, the proposed study is critical to identify cost-effective SCPP program designs in real-world settings. In support of this research, Dr. Shulamite S. Huang is applying for a K-25 award. Dr. Huang, a health economist specializing in the study of the dental market at New York University College of Dentistry, is establishing herself as a young investigator in economic evaluations of dental interventions and oral health services research. This award will allow Dr. Huang to integrate her background and experience in health economics and policy evaluation with additional training in clinical research methods and evaluation of clinical interventions, and work towards reducing health disparities and improving health care delivery and quality. In Aim 1, Dr. Huang will determine the impact of SCPPs on oral health outcomes, after accounting for prior dental care use. As part of this aim, Dr. Huang will link oral health outcomes data from a pragmatic clinical trial comparing two different SCPP program designs to New York Medicaid/CHIP claims data at the individual level. In Aim 2, Dr. Huang will evaluate the impact of SCPPs on utilization and spending on care for dental conditions for children enrolled in Medicaid/CHIP. In Aim 3, Dr. Huang will evaluate the cost-effectiveness and budget impact of different SCPP program designs relative to a no-SCPP scenario. This research will launch Dr. Huang’s career in oral health services research, which aims to combine mathematical modeling with large dataset analyses to study the impact of changes in dental care delivery and payment on large populations. This work will be in the form of an R01 grant application prior to the completion of the K-award. Dr. Huang has assembled a mentoring team comprised of a primary mentor, Dr. Heather Gold, an expert in population health research and economic evaluations of clinical & behavioral interventions and Associate Professor at NYU Langone Health and School of Medicine; and one co-mentor, Dr. Richard Niederman, a dentist and Professor and Chair of the Department of Epidemiology and Health Promotion at NYU College of Dentistry, who conducts the SCPP pragmatic clinical trial providing data for this study.