title: Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees.
abstract: OBJECTIVE
  To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB).
  
  
  METHODS
  Observational study using Medicaid claims data (2000-2006).
  
  
  METHODS
  Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals.
  
  
  METHODS
  A total of 209 285 children enrolled in Medicaid at age 6 months.
  
  
  METHODS
  Into the Mouths of Babes visits included screening, parental counseling, topical fluoride application, and referral to dentists, if needed. The cost-effectiveness analysis used the Medicaid program perspective and a propensity score-matched sample with regression analysis to compare children with 4 or more vs 0 IMB visits.
  
  
  METHODS
  Dental treatments and Medicaid payments for children up to age 6 years enabled assessment of the likelihood of whether IMB was cost-saving and, if not, the additional payments per hospital episode avoided.
  
  
  RESULTS
  Into the Mouths of Babes is 32% likely to be cost-saving, with discounting of benefits and payments. On average, IMB visits cost $11 more than reduced dental treatment payments per person. The program almost breaks even if future benefits from prevention are not discounted, and it would be cost-saving with certainty if IMB services could be provided at $34 instead of $55 per visit. The program is cost-effective with 95% certainty if Medicaid is willing to pay $2331 per hospital episode avoided.
  
  
  CONCLUSIONS
  Into the Mouths of Babes improves dental health for additional payments that can be weighed against unmeasured hospitalization costs.
authors.affiliation: Department of Health Policy and Management, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. sally_stearns@unc.edu
authors.forename: Sally C
authors.initials: SC
authors.lastname: Stearns
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Kranz
authors.forename: Bhavna T
authors.initials: BT
authors.lastname: Pahel
authors.forename: Rocio B
authors.initials: RB
authors.lastname: Quiñonez
mesh_terms: D002648:Child; D002675:Child, Preschool; D017046:Cost Savings / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D019140:Dental Care for Children / Q000191:economics* / Q000458:organization & administration; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005102:Health Expenditures / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D018803:Models, Economic; D009657:North Carolina; D010043:Outcome and Process Assessment, Health Care; D011314:Preventive Health Services / Q000191:economics* / Q000458:organization & administration; D011320:Primary Health Care / Q000191:economics*; D015397:Program Evaluation; D057216:Propensity Score; D012017:Referral and Consultation / Q000191:economics; D014481:United States