title: Cost-analysis of teledentistry in residential aged care facilities.
abstract: BACKGROUND
  The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination.
  
  
  METHODS
  The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional.
  
  
  RESULTS
  It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident.
  
  
  CONCLUSIONS
  Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.
authors.affiliation: Oral Health CRC, Melbourne Dental School, University of Melbourne, Melbourne, Australia r.marino@unimelb.edu.au.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Mariño
authors.affiliation: Deakin Health Economics, Deakin University, Melbourne, Australia.
authors.forename: Utsana
authors.initials: U
authors.lastname: Tonmukayakul
authors.affiliation: Oral Health CRC, Melbourne Dental School, University of Melbourne, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Manton
authors.affiliation: Centre for Informatics and Applied Optimisation, Federation University, Ballarat, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stranieri
authors.affiliation: Melbourne Networked Society Institute, University of Melbourne, Melbourne, Australia.
authors.forename: Ken
authors.initials: K
authors.lastname: Clarke
mesh_terms: D003365:Costs and Cost Analysis; D016321:Dental Care for Aged / Q000191:economics* / Q000379:methods*; D003813:Dentistry; D004468:Economics, Dental; D006707:Homes for the Aged; D006801:Humans; D009726:Nurses; D010781:Photography; D012424:Rural Population; D017216:Telemedicine / Q000191:economics* / Q000379:methods*; D014739:Victoria
keywords: Economic evaluation; cost-analysis; older adults; oral health; teledentistry