Four-year cost-utility analyses of sealed and nonsealed first permanent molars in Iowa Medicaid-enrolled children

Patita Bhuridej; Raymond A Kuthy; Stephen D Flach; Keith E Heller; Deborah V Dawson; Michael J Kanellis; Peter C Damiano

doi:10.1111/j.1752-7325.2007.00025.x

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Four-year cost-utility analyses of sealed and nonsealed first permanent molars in Iowa Medicaid-enrolled children

Journal article

Peer reviewed

Four-year cost-utility analyses of sealed and nonsealed first permanent molars in Iowa Medicaid-enrolled children

Patita Bhuridej, Raymond A Kuthy, Stephen D Flach, Keith E Heller, Deborah V Dawson, Michael J Kanellis and Peter C Damiano

Journal of public health dentistry, Vol.67(4), pp.191-198

2007

DOI: 10.1111/j.1752-7325.2007.00025.x

PMID: 18087989

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Abstract

Dental sealants, by their ability to prevent caries and maintain teeth in better health, have some inherent utility to individuals, programs, or society. This study assessed the 4-year incremental cost utility of sealing first permanent molars of 6-year-old Iowa Medicaid enrollees from a societal perspective and identified the group of teeth or children in whom sealants are most cost effective. Dental services for first permanent molars were assessed using claims and encounter data for a group of continuously enrolled Medicaid enrollees who turned 6 between 1996 and 1999. Previously published utilities were used to weight the different health states. The weighted sum of outcomes [Quality-Adjusted Tooth-Years (QATYs)] was the measure of effectiveness. Costs and QATYs were discounted to the time of the child's sixth birthday. For all first molars, the cost of treatment associated with sealed teeth was higher but the utility was also slightly higher over the 4-year period. The relative incremental cost per 0.19 QATY ratio [changing the health state from a restored tooth (utility= 0.81) to a nonrestored tooth (utility = 1)] by sealing the molar ranged from $36.7 to $83.5 per 0.19 QATY. The incremental cost/QATY ratio was lower for sealing lower utilizers and for mandibular versus maxillary molars. Sealants improved overall utility of first permanent molars after 4 years. The 4-year cost/QATY ratio of sealing the first permanent molar varied by arch and type of utilizers. Sealing first permanent molars in lower dental utilizers is the most cost-effective approach for prioritizing limited resources.

Dental Care for Children - economics

Risk Assessment - methods

Medicaid - economics

Dental Caries - economics

Dental Health Surveys

Outcome Assessment (Health Care)

Dentition, Permanent

Humans

Insurance Claim Review

Male

Molar

Pit and Fissure Sealants - economics

Dental Caries - epidemiology

Cost-Benefit Analysis

Pit and Fissure Sealants - therapeutic use

Dental Restoration, Permanent - economics

Female

Iowa - epidemiology

Retrospective Studies

Dental Caries - prevention & control

Child

Cohort Studies

Dental Medicaid

Details

Title: Subtitle: Four-year cost-utility analyses of sealed and nonsealed first permanent molars in Iowa Medicaid-enrolled children
Creators: Patita Bhuridej - Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
Raymond A Kuthy
Stephen D Flach
Keith E Heller
Deborah V Dawson
Michael J Kanellis
Peter C Damiano
Resource Type: Journal article
Publication Details: Journal of public health dentistry, Vol.67(4), pp.191-198
Publisher: United States
DOI: 10.1111/j.1752-7325.2007.00025.x
PMID: 18087989
ISSN: 0022-4006
eISSN: 1752-7325
Language: English
Date published: 2007
Academic Unit: Preventive and Community Dentistry; Health Management and Policy; Dental Clinic Administration; Biostatistics; Pediatric Dentistry; Public Policy Center (Archive); Dental Research; University College Courses; Oral Health Policy Research
Record Identifier: 9983917670602771

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