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BMC Health Services Research

, 16:590

Utilization, expenditure, economics and financing systems

Abstract

BackgroundThe burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand Wits has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale.

MethodsIn 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters.

ResultsThe total economic costs were R813.701 US$76,048. The cost of screening and treatment per patient were R331 US$31 and R743 US$69 respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %.

ConclusionsExpanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

KeywordsMobile dental care Oral health Cost analysis School based program AbbreviationsCOHOPCommunity Oral Health Outreach Program

CPIConsumer Price Index

NHINational Health Insurance

PHCPrimary Health Care

PRICELESSPriority Cost Effective Lessons for Systems Strengthening

RSouth African Rand

US$United States Dollar

WHOWorld Health Organisation

WITSUniversity of the Witwatersrand

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Autor: M. P. Molete - L. Chola - K. J. Hofman

Fuente: https://link.springer.com/







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