Cost-effectiveness ratio of public oral care from a health service and societal perspective in Brazil, a middle-income country

Article type
Authors
Alves Ferreira C, Alfredo de Salles Loureiro C
Abstract
Objective: To evaluate the cost-effectiveness ratios (CER) and the economic burden of oral care in the public health service of a middle-income country - Brazil - from both a health service and society's perspective.
Methods: Longitudinal data from 7825 patients treated by 13 dentists and two hygienists during one year. The outcome considered was completed treatment. All costs such as are overhead, capital and operational costs, were considered. Two components of cost were taken into account: cost opportunity and depreciation, calculated from the update tax of the initial capital. A sensitivity analysis was undertaken.
Results: From the service perspective, the best CER was for emergencies in all specialties ($10.99 to $12.98), followed by prevention, operative dentistry, endodontics and prosthesis. From the society's perspective, the best CER was for emergencies in all specialties ($1.43 to $2.31), followed by endodontics, prevention, prosthesis and operative dentistry.
Conclusions: The priority differs both from the service perspective and the society's perspective. From a health service perspective, the costs for elective care, including prevention, was close to the costs of high-income countries. From society's perspective, the CER for prevention in clinical settings was unfavorable for recommending as a priority for poor populations. The societal perspective is an essential approach to resources allocation decision-making.