Cost-effectiveness analysis of periodontal disease control.
Cost-effectiveness analysis was used to evaluate alternative methods of periodontal disease control. The alternatives considered included non-surgical and surgical procedures as well as the use of antimicrobial agents. Data on costs were obtained from American Dental Association publications of average charges for periodontal services. The concept of quality-adjusted tooth-years (QATYs) was developed to provide an outcome measure which could be compared across treatments. The conclusions of this analysis are as follows: (1) Conservative non-surgical treatments for periodontal disease control not only have costs lower than surgical alternatives, as would be expected, but also maximize expected quality-adjusted tooth-years over a wide range of estimates; (2) antimicrobial therapy used as an adjunct to non-surgical treatment is likely to be both effective and cost-effective; and (3) quality of tooth-years is a critical consideration in the determination of outcome of periodontal treatment. For example, when tooth-years are not adjusted for quality, differences between treatments are diminished, and surgical treatment becomes as good as or better than more conservative treatments for some levels of disease severity.
Antczak-Bouckoms
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AA
Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Weinstein
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MC
D000543:Alveoloplasty / Q000191:economics; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003777:Dental Prophylaxis / Q000191:economics; D012534:Dental Scaling / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D008795:Metronidazole / Q000191:economics / Q000627:therapeutic use; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D010510:Periodontal Diseases / Q000191:economics / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy; D010514:Periodontal Pocket / Q000191:economics / Q000601:surgery; D019057:Quality-Adjusted Life Years; D015895:Relative Value Scales; D016745:Root Planing / Q000191:economics; D012680:Sensitivity and Specificity; D013357:Subgingival Curettage / Q000191:economics; D013524:Surgical Flaps / Q000191:economics; D013752:Tetracycline / Q000191:economics / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D013752:Tetracycline