A Longitudinal Study of Cost-Benefit Analysis (CBA) of National Health Insurance Scheme for Children Teeth Fluoridation and Anti-decay Program

• Main Authors: Ying-Mei Chang, 張瑛玫
• Other Authors: 馬作鏹
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/08371548473826669634

碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 97 === Objective: Children teeth fluoridation and anti-decay treatment program was implemented by Bureau of Nation Health Insurance from July 1 2004 for over four years. The author analyzes an insurance database to evaluate the utilization of dental care preventive service and cost-benefit effectiveness (CBA) of teeth fluoridation and anti-decay treatment program in central part of Taiwan. Methods: A retrospective study was conducted using an insurance database from Bureau of Nation Health Insurance - Central regional branch with registered children born in 2001 who received teeth fluoridation and anti-decay program. The difference of utilization of dental care preventive service analysis was based on each individual child’s character and required dental treatment. For cost-benefit analysis, children were selected who were eligible receiving or non- receiving this benefit from July 1, 2004 till 2007. Two groups were compared by frequency matching analysis, based on sex, medical provide territories, insured fee. Additional Incremental benefit/cost method (ICB) of cost-benefit analysis (CBA) is also conducted to evaluate the service providing cost increasing (△C) and dental treatment cost decreasing effectiveness (△B). Results: No statistic significant differences between children sex and receiving or non-receiving this benefit factor, however, significant difference were showed at medical providing territories and insured fee factor (p<.0001). Children who receiving teeth fluoridation every half year (including 2,3,4 times), the average visiting frequency and treatment cost had statistic significant differences with children who receive single teeth fluoridation course(p<.05), i.e., the final teeth fluoridation in the last six months is less than the initial teeth fluoridation in the first half year. This result is also showed in dental caries and the pulpitis treatment (p<.05). Conclusions: In the selected children, parent’s decision making and territory variance (ex: cities vs. townships) gave influence of children to receive teeth fluoridation and incidence rate of caries. In the meantime, the analysis result of health insurance utilization is same as foreign countries’ study result, that is, teeth fluoridation may reduce dental treatment cost and utilization of dental care service. In addition, the assumption in this research model, cost-benefit effectiveness (CBA) analysis shows that present fluoridation benefit cannot cover its own cost. Recommendation: Based on this research, the teeth fluoridation may reduce the dental care service cost. However, the total saving cost cannot cover the government investment. Although cost saving is not the priority consideration factor of every beneficial program, but facing financial limitation and increasing public health expenditure, government needs to further study the balance of service providing scope and financial impact, which becomes an issue that can be discussed . Hope this study can provide a reference for future public health resource allocation and policy amendment.