广州市适龄儿童六龄齿免费窝沟封闭项目卫生经济效益分析
|
摘要
目的评估广州市适龄儿童六龄齿免费封窝沟闭项目的卫生经济效果和效益。方法通过计算享受免费六龄齿窝沟封闭的学生和经口腔检查符合窝沟封闭条件而没有进行窝沟封闭的学生之间的第一恒磨牙龋患差异,推算出由于项目实施而产生的效果,再进行项目收益和成本效果及成本效益分析。结果 2011年和2012年由于开展适龄儿童免费窝沟封闭而减少的第一恒磨牙的患龋人数和牙数分别是2 247人3 652颗牙和5 417人9 112颗牙。项目2年的成本效果比分别为453.03∶1和384.14∶1,效益现值总额分别约为647.4万元和1 615.3万元,成本效益比为1∶3.79和1∶3.13,结果存在城乡差异。结论广州市适龄儿童免费窝沟封闭项目有较好的成本-效益,建议项目向农村地区适当倾斜,实现政府资源的有效配置。
Objective To evaluate the health economic effects and benefits of the free fissure sealing for the first permanent molar among the appropriate age children in Guangzhou. Methods The effect of fissure sealing was evaluated by calculating the caries rate between the students who had received fissure sealing and those who should have received the fissure sealing but actually had not. At the same time, project cost effectiveness and benefit analyses were conducted. Results Compared with the control group, the number of students suffering from caries in the first permanent molar and decayed teeth were reduced by 2247 students with 3652 teeth in 2011 and 5417 students with 9112 teeth in 2012. The cost-effectiveness ratios for the two years were 453.03: 1 and 384.14: 1. The total values of the two years were about 6.474 million and 16.153 million Yuan, and the cost-benefit ratios were 1:3.79 and 1:3.13 respectively. Conclusion The free fissure sealing project in Guangzhou has a good cost-benefit, and to achieve effective allocation of government resources, the project should be tilted properly to the rural areas.
Objective To evaluate the health economic effects and benefits of the free fissure sealing for the first permanent molar among the appropriate age children in Guangzhou. Methods The effect of fissure sealing was evaluated by calculating the caries rate between the students who had received fissure sealing and those who should have received the fissure sealing but actually had not. At the same time, project cost effectiveness and benefit analyses were conducted. Results Compared with the control group, the number of students suffering from caries in the first permanent molar and decayed teeth were reduced by 2247 students with 3652 teeth in 2011 and 5417 students with 9112 teeth in 2012. The cost-effectiveness ratios for the two years were 453.03: 1 and 384.14: 1. The total values of the two years were about 6.474 million and 16.153 million Yuan, and the cost-benefit ratios were 1:3.79 and 1:3.13 respectively. Conclusion The free fissure sealing project in Guangzhou has a good cost-benefit, and to achieve effective allocation of government resources, the project should be tilted properly to the rural areas.
引文
[1]张大华,张衍蓉,安伟,等.儿童口腔疾病综合干预的实践[J].口腔疾病防治,2016,24(9):549-553.
[2]潘恒标,谢超益,顾豪勇,等.学龄儿童口腔健康干预效果比较[J].预防医学,2016,28(8):846-851.
[3]Bromo F,Guida A,Santoro G,et al.Pit and fissure sealants:review of literature and application technique[J].Minerva Stomatologica,2011,60(10):529-541.
[4]Gooch BF,Griffin SO,Gray SK,et al.Preventing dental caries through school-based sealant programs Updated recommendations and reviews of evidence[J].Journal of the American Dental Association,2009,140(11):1356-1365.
[5]李骏,王燕波,张松杰,等.西安市新城区学龄儿童第一恒磨牙窝沟封闭干预效果评估[J].中国儿童保健杂志,2015,23(8):807-810.
[6]陈昕,张建军,任洪芋.中西部地区儿童口腔疾病综合干预项目预防儿童龋病的2年效果评价[J].中国美容医学,2014,23(21):1835-1837.
[7]Bertrand E,Mallis M,Bui NM,et al.Cost-effectiveness simulation of a Universal publicly funded sealants application program[J].Journal of Public Health Dentistry,2011,71(1):38-45.
[8]姚梦思.从4E原则考察公共卫生支出绩效智富时代[J].智富时代,2016,12(7):117-117.
[9]Ghaname ES,Ritter AV,Heymann HO,et al.Correlation between laser fluorescence readings and volume of tooth preparation in incipient occlusal caries in vitro[J].Journal of Esthetic and Restorative Dentistry:Official Publication of the American Academy of Esthetic Dentistry...[et al.],2010,22(1):31-39.
[10]Locker D,Jokovic A,Kay E J.Prevention.Part 8:the use of pit and fissure sealants in preventing caries in the permanent dentition of children[J].British Dental Journal,2003,195(7):375-378.
[11]蒋连权.学龄前儿童窝沟封闭预防龋齿治疗情况调查[J].中国公共卫生管理,2016,32(1):138-140.
[12]Meyer-Lueckel H,Paris S,Mueller J,et al.Influence of the application time on the penetration of different dental adhesives and a fissure sealant into artificial subsurface lesions in bovine enamel[J].Dental Materials:Official Publication of the Academy of Dental Materials,2006,22(1):22-28.
[13]沈培,张吉凯.公共卫生项目成本-效益分析中的社会贴现率研究[J].中国卫生经济,2010,29(6):72-73.
[14]Brouwer WBF,Niessen LW,Postma MJ,et al.Need for differential discounting of costs and health effects in cost effectiveness analyses[J].BMJ,2005,331:446-448.
[15]Quin軌onez RB,Downs SM,Shugars D,et al.Assessing cost-effectiveness of sealant placement in children[J].Journal of Public Health Dentistry,2005,65(2):82-89.
[16]Sakuma S,Yoshihara A,Miyazaki H,et al.Economic evaluation of a school-based combined program with a targeted pit and fissure sealant and fluoride mouth rinse in Japan[J].The Open Dentistry Journal,2010,4:230-236.
[17]Weintraub JA,Stearns SC,Burt BA,et al.A retrospective analysis of the cost-effectiveness of dental sealants in a children's health center[J].Social Science&Medicine(1982),1993,36(11):1483-1493.
[18]Naaman R,El-Housseiny AA,Alamoudi N.The use of pit and fissure Sealants-A literature review[J].Dentistry Journal,2017,5(4):1-19.
[2]潘恒标,谢超益,顾豪勇,等.学龄儿童口腔健康干预效果比较[J].预防医学,2016,28(8):846-851.
[3]Bromo F,Guida A,Santoro G,et al.Pit and fissure sealants:review of literature and application technique[J].Minerva Stomatologica,2011,60(10):529-541.
[4]Gooch BF,Griffin SO,Gray SK,et al.Preventing dental caries through school-based sealant programs Updated recommendations and reviews of evidence[J].Journal of the American Dental Association,2009,140(11):1356-1365.
[5]李骏,王燕波,张松杰,等.西安市新城区学龄儿童第一恒磨牙窝沟封闭干预效果评估[J].中国儿童保健杂志,2015,23(8):807-810.
[6]陈昕,张建军,任洪芋.中西部地区儿童口腔疾病综合干预项目预防儿童龋病的2年效果评价[J].中国美容医学,2014,23(21):1835-1837.
[7]Bertrand E,Mallis M,Bui NM,et al.Cost-effectiveness simulation of a Universal publicly funded sealants application program[J].Journal of Public Health Dentistry,2011,71(1):38-45.
[8]姚梦思.从4E原则考察公共卫生支出绩效智富时代[J].智富时代,2016,12(7):117-117.
[9]Ghaname ES,Ritter AV,Heymann HO,et al.Correlation between laser fluorescence readings and volume of tooth preparation in incipient occlusal caries in vitro[J].Journal of Esthetic and Restorative Dentistry:Official Publication of the American Academy of Esthetic Dentistry...[et al.],2010,22(1):31-39.
[10]Locker D,Jokovic A,Kay E J.Prevention.Part 8:the use of pit and fissure sealants in preventing caries in the permanent dentition of children[J].British Dental Journal,2003,195(7):375-378.
[11]蒋连权.学龄前儿童窝沟封闭预防龋齿治疗情况调查[J].中国公共卫生管理,2016,32(1):138-140.
[12]Meyer-Lueckel H,Paris S,Mueller J,et al.Influence of the application time on the penetration of different dental adhesives and a fissure sealant into artificial subsurface lesions in bovine enamel[J].Dental Materials:Official Publication of the Academy of Dental Materials,2006,22(1):22-28.
[13]沈培,张吉凯.公共卫生项目成本-效益分析中的社会贴现率研究[J].中国卫生经济,2010,29(6):72-73.
[14]Brouwer WBF,Niessen LW,Postma MJ,et al.Need for differential discounting of costs and health effects in cost effectiveness analyses[J].BMJ,2005,331:446-448.
[15]Quin軌onez RB,Downs SM,Shugars D,et al.Assessing cost-effectiveness of sealant placement in children[J].Journal of Public Health Dentistry,2005,65(2):82-89.
[16]Sakuma S,Yoshihara A,Miyazaki H,et al.Economic evaluation of a school-based combined program with a targeted pit and fissure sealant and fluoride mouth rinse in Japan[J].The Open Dentistry Journal,2010,4:230-236.
[17]Weintraub JA,Stearns SC,Burt BA,et al.A retrospective analysis of the cost-effectiveness of dental sealants in a children's health center[J].Social Science&Medicine(1982),1993,36(11):1483-1493.
[18]Naaman R,El-Housseiny AA,Alamoudi N.The use of pit and fissure Sealants-A literature review[J].Dentistry Journal,2017,5(4):1-19.