Economic Evaluation of School-Based Caries Prevention Programs

本项目的主要目标是通过以下措施改善口腔保健服务，减少健康不公平现象： 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。到 为了实现这一目标，拟议的研究有三个主要目标，即评估 以学校为基础的龋齿预防计划（SCPP）的计划设计和牙齿护理影响的事先使用（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， 两个多站点SCPP和纽约医疗补助索赔数据的实用临床试验。既往系统性综述 SCPP在SCPP方案设计和实施中发现了重大变化。结果导致 拟议的研究是至关重要的，以确定成本效益的SCPP程序设计在现实世界的设置。 为了支持这项研究，Shulamite S。黄正在申请K-25奖。黄医生，健康 纽约大学牙科学院专门研究牙科市场的经济学家， 确立了自己作为一个年轻的研究人员在经济评估的牙科干预和口腔健康 服务研究。这个奖项将使黄博士能够整合她在健康方面的背景和经验 经济学和政策评估，并在临床研究方法和临床研究评估方面进行额外培训。 我们将继续努力采取有效的干预措施，并努力减少健康差距，改善医疗保健服务和质量。 在目标1中，黄博士将在考虑以下因素后确定SCPP对口腔健康结果的影响： 以前的牙齿护理使用。作为这一目标的一部分，黄博士将从一个务实的临床研究中链接口腔健康结果数据。 比较两种不同的SCPP计划设计与纽约Medicaid/CHIP索赔数据的试验， 水平在目标2中，黄博士将评估SCPP对牙科保健利用和支出的影响。 参加Medicaid/CHIP的儿童的条件。在目标3中，黄博士将评估成本效益， 不同SCPP计划设计相对于无SCPP方案的预算影响。这项研究将启动博士。 黄博士的职业生涯在口腔健康服务研究，其目的是联合收割机结合数学建模与大型 数据集分析，以研究牙科保健服务和支付的变化对大规模人群的影响。 这项工作将在K奖完成之前以R 01赠款申请的形式进行。 黄博士组建了一个由主要导师石楠戈尔德博士、 人口健康研究和临床与行为干预经济评估专家， 纽约大学Langone健康与医学院副教授;以及一位共同导师Richard博士 尼德曼是一名牙医，也是纽约大学流行病学和健康促进系的教授和主任。 他进行了SCPP实用临床试验，为这项研究提供了数据。

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.