Cost-effectiveness simulation of a universal publicly funded sealants application program.
OBJECTIVE
No cost-effectiveness evaluation of pit and fissure sealants has ever been carried out in Quebec. The objective of this study was to simulate a publicly funded program of pit and fissure administration, either in the public or private sectors, and compare these hypothetical situations with the current one, i.e., a publicly funded, school-based selective program.


METHODS
A Markov model was developed using a virtual population of 8-year-old children that was monitored over a time span of 10 years. The incremental cost per child without decay was computed.


RESULTS
The current situation and a publicly funded program in the public sector were more cost-effective than the other option: a universal, publicly funded, private practice. However, the most cost-effective option varied, depending on the incidence of decay and the proportion of children identified as being at high-risk for decay.


CONCLUSIONS
By implementing a school-based program of universal pit and fissure sealant application, access to preventive dental care could be improved at an equivalent cost-effectiveness to the current one.
Bertrand
Elise
E
Preventive and Social Medicine Department, Laval University, Quebec, Canada.
Mallis
Majid
M
Bui
Nguyen Minh
NM
Reinharz
Daniel
D
D002648:Child; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D017048:Health Care Costs; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D008963:Molar / Q000473:pathology; D017063:Outcome Assessment, Health Care; D010895:Pit and Fissure Sealants / Q000191:economics*; D017149:Private Sector / Q000191:economics; D017150:Public Sector / Q000191:economics*; D011792:Quebec; D019233:Retreatment; D012307:Risk Factors; D012571:School Dentistry / Q000191:economics; D012680:Sensitivity and Specificity; D014584:User-Computer Interface
D010895:Pit and Fissure Sealants