title: Relative cost-effectiveness of home visits and telephone contacts in preventing early childhood caries.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of a home-visit intervention conducted by oral health therapists relative to a telephone-based alternative and no intervention.
  
  
  METHODS
  A Markov model was built to combine data on dental caries incidence, dental treatments, quality of life and costs for a cohort of children from age 6 months to 6 years. The probabilities of developing caries and subsequent treatments were derived primarily from the key intervention study. The outcome measures were costs (US dollars), quality-adjusted life years (QALYs) and the number of carious teeth prevented. One-way and probabilistic sensitivity analyses were used to test the stability of the model.
  
  
  RESULTS
  For every group of 100 children, the model predicted that having the home-visit intervention would save $167 032 and telephone contacts $144 709 over 5½ years relative to no intervention (usual care). The home visits and telephone intervention would prevent 113 and 100 carious teeth (per 100 children) relative to no intervention in a period of 5½ years. Sensitivity analysis showed that a lower rate of caries reduced the intervention's cost-effectiveness primarily through reducing general anaesthesia costs. The home visits and telephone interventions resulted in 7 and 6 QALYs, respectively, gained over the usual care group for the 100 children over 5½ years. Both interventions were 'dominant,' as they saved costs and produced health benefits over usual care.
  
  
  CONCLUSIONS
  Both the home visits and telephone-based community interventions conducted by oral health therapists were highly cost-effective than no intervention in preventing early childhood caries.
authors.affiliation: Centre for Paediatric Dentistry, Oral Health Centre, The University of Queensland, Herston, Qld, Australia.
authors.forename: Rongzhen
authors.initials: R
authors.lastname: Koh
authors.affiliation: Oral Health Program (Logan-Beaudesert Division), Metro South Health, Logan City, Qld, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Pukallus
authors.affiliation: Centre for Applied Health Economics, Menzies Health Institute, Queensland, School of Medicine, Griffith University, Meadowbrook, Qld, Australia.
authors.forename: Sanjeewa
authors.initials: S
authors.lastname: Kularatna
authors.affiliation: Centre for Applied Health Economics, Menzies Health Institute, Queensland, School of Medicine, Griffith University, Meadowbrook, Qld, Australia.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Gordon
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.affiliation: Centre for Paediatric Dentistry, Oral Health Centre, The University of Queensland, Herston, Qld, Australia.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Walsh
authors.affiliation: Centre for Paediatric Dentistry, Oral Health Centre, The University of Queensland, Herston, Qld, Australia.
authors.forename: Wan Kim
authors.initials: WK
authors.lastname: Seow
mesh_terms: D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D019140:Dental Care for Children / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D003731:Dental Caries / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006792:House Calls / Q000191:economics; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009910:Oral Hygiene / Q000191:economics / Q000193:education; D011313:Preventive Dentistry / Q000191:economics / Q000379:methods; D019057:Quality-Adjusted Life Years; D013689:Telephone
keywords: Markov model; cost-effectiveness; early childhood caries; home-visit intervention; telephone intervention