Journal article
Cost-Effectiveness of Pit-and-Fissure Sealants on Primary Molars in Medicaid-Enrolled Children
American journal of public health (1971), Vol.104(3), pp.555-561
03/01/2014
DOI: 10.2105/AJPH.2013.301588
PMCID: PMC3953771
PMID: 24432941
Abstract
Objectives. We compared the incremental cost-effectiveness of 2 primary molar sealant strategies-always seal and never seal-with standard care for Medicaid-enrolled children.
Methods. We used Iowa Medicaid claims data (2008-2011), developed a tooth-level Markov model for 10 000 teeth, and compared costs, treatment avoided, and incremental cost per treatment avoided for the 2 sealant strategies with standard care.
Results. In 10 000 simulated teeth, standard care cost $214 510, always seal cost $232 141, and never seal cost $186 010. Relative to standard care, always seal reduced the number of restorations to 340 from 2389, whereas never seal increased restorations to 2853. Compared with standard care, always seal cost $8.12 per restoration avoided (95% confidence interval [CI] = $4.10, $12.26; P <=.001). Compared with never seal, standard care cost $65.62 per restoration avoided (95% CI = $52.99, $78.26; P <=.001).
Conclusions. Relative to standard care, always sealing primary molars is more costly but reduces subsequent dental treatment. Never sealing costs less but leads to more treatment. State Medicaid programs that do not currently reimburse dentists for primary molar sealants should consider reimbursement for primary molar sealant procedures as a population-based strategy to prevent tooth decay and reduce later treatment needs in vulnerable young children.
Details
- Title: Subtitle
- Cost-Effectiveness of Pit-and-Fissure Sealants on Primary Molars in Medicaid-Enrolled Children
- Creators
- Donald L. Chi - University of New MexicoDavid N. van der Goes - University of New MexicoJohn P. Ney - University of Washington
- Resource Type
- Journal article
- Publication Details
- American journal of public health (1971), Vol.104(3), pp.555-561
- Publisher
- Amer Public Health Assoc Inc
- DOI
- 10.2105/AJPH.2013.301588
- PMID
- 24432941
- PMCID
- PMC3953771
- ISSN
- 0090-0036
- eISSN
- 1541-0048
- Number of pages
- 7
- Grant note
- K08DE020856 / NATIONAL INSTITUTE OF DENTAL & CRANIOFACIAL RESEARCH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) William T. Grant Foundation K08DE020856; L60MD003921; U54DE019346 / National Institute of Dental and Craniofacial Research, US National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR)
- Language
- English
- Date published
- 03/01/2014
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984283851402771
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