Abstract
BackgroundThe objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components.MethodsFive specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4).ResultsA total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P < 0.001). Providers generally spent most on consumables while patients spent most on transportation.ConclusionsCost of providing dental treatment for periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme.
Highlights
The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components
Clinic selection The sampling frame for clinic selection comprised all eighteen Ministry of Health specialist periodontal clinics located throughout the country
Direct medical or dental costs refer to resources consumed for dental and periodontal treatment performed for periodontitis patients in this study
Summary
The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Periodontitis is an established and widespread chronic disease, yet its burden on healthcare costs remain largely neglected. Most studies estimating costs of periodontal care focus on cost of specific periodontal treatment modalities [13,14,15] but not the cost of managing the whole spectrum of the disease itself. The COI study approach is a descriptive study that can provide information to measure economic burden of a disease using a prevalence-based or an incidence-based approach. Prevalence-based COI studies measure current economic burden of a disease in a given period, whereas incidence-based approach measures economic burden from the onset of disease until cure or death and involves estimating the lifetime costs of new cases which have their onset in a given period of time [16]
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