Economic assessment of a six-year project with extensive use of dental hygienists in the dental care of children: a pilot study

Abstract

The aim of the study was to assess the economic efficiency of an alternative division of labour based on an extensive use of dental hygienists combined with a reduced input of dentists. A test clinic was compared to a conventionally run public clinic in respect of dental and financial effects in the dental care of children. The study comprised 80 adolescents, born in 1975, in their 13th to 18th years. The assessment of economic efficiency was based on a cost/benefit analysis on the clinic level, in which the cost was defined as the difference between the test clinic and the control clinic in yearly running variable costs per child, and the benefit as the difference in the yearly caries increment multiplied by a value factor. The results showed statistically significant, lower caries incidence in the test group. Regression analyses, estimating a caries incidence function gave statistically significant explanation values for the variables "Caries prevalence" at 13 years of age' and 'Clinic'. The cost/benefit analysis showed a benefit/cost ratio of 1.48. The division of labour at the test clinic is discussed as a possible main factor for the outcome and suggests further experiments on a larger scale. The study can be regarded as a pilot, intended to be followed by a comprehensive study using a larger number of patients of different ages and more control clinics.