TY - JOUR
T1 - Economic evaluation of a community dental care model for people experiencing homelessness
AU - Nguyen, Tan Minh
AU - Witton, Robert
AU - Withers, Lyndsey
AU - Paisi, Martha
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12/12
Y1 - 2024/12/12
N2 - Aim The study aims to conduct economic evaluation of the Peninsula Dental Social Enterprise (PDSE) programme for people experiencing homelessness over an 18-month period, when compared to a hypothetical base-case scenario (‘status quo'). Methods A decision tree model was generated in TreeAge Pro Healthcare 2024. Benefit-cost analysis and cost-effectiveness analysis were performed using data informed by the literature and probabilistic sensitivity analysis (Monte Carlo simulation with 1,000 cycles). The pre-determined willingness-to-pay threshold was estimated to be £59,502 per disability-adjusted life year (DALY) averted. Costs (£) and benefits were valued in 2020 prices. Health benefits in DALYs included dental treatment for dental caries, periodontitis and severe tooth loss. Results The hypothetical cohort of 89 patients costs £11,502 (SD: 488) and £57,118 (SD: 2,784) for the base-scenario and the PDSE programme, respectively. The health outcomes generated 0.9 (SD: 0.2) DALYs averted for the base-case scenario, and 5.4 (SD: 0.9) DALYs averted for the PDSE programme. The DALYs averted generated £26,648 (SD: 4,805) and £163,910 (SD: 28,542) in benefits for the base-scenario and the PDSE programme, respectively. The calculated incremental benefit-cost ratio was 3.02 (SD: 0.5) and incremental cost-effectiveness ratio was £10,472 (SD: 2,073) per DALY averted. Uncertainty analysis demonstrated that the PDSE programme was 100% cost-effective. Conclusions Funding a targeted dental programme from the UK healthcare perspective that provides timely and affordable access to dental services for people experiencing homelessness is cost-effective.
AB - Aim The study aims to conduct economic evaluation of the Peninsula Dental Social Enterprise (PDSE) programme for people experiencing homelessness over an 18-month period, when compared to a hypothetical base-case scenario (‘status quo'). Methods A decision tree model was generated in TreeAge Pro Healthcare 2024. Benefit-cost analysis and cost-effectiveness analysis were performed using data informed by the literature and probabilistic sensitivity analysis (Monte Carlo simulation with 1,000 cycles). The pre-determined willingness-to-pay threshold was estimated to be £59,502 per disability-adjusted life year (DALY) averted. Costs (£) and benefits were valued in 2020 prices. Health benefits in DALYs included dental treatment for dental caries, periodontitis and severe tooth loss. Results The hypothetical cohort of 89 patients costs £11,502 (SD: 488) and £57,118 (SD: 2,784) for the base-scenario and the PDSE programme, respectively. The health outcomes generated 0.9 (SD: 0.2) DALYs averted for the base-case scenario, and 5.4 (SD: 0.9) DALYs averted for the PDSE programme. The DALYs averted generated £26,648 (SD: 4,805) and £163,910 (SD: 28,542) in benefits for the base-scenario and the PDSE programme, respectively. The calculated incremental benefit-cost ratio was 3.02 (SD: 0.5) and incremental cost-effectiveness ratio was £10,472 (SD: 2,073) per DALY averted. Uncertainty analysis demonstrated that the PDSE programme was 100% cost-effective. Conclusions Funding a targeted dental programme from the UK healthcare perspective that provides timely and affordable access to dental services for people experiencing homelessness is cost-effective.
UR - http://www.scopus.com/inward/record.url?scp=85211922243&partnerID=8YFLogxK
U2 - 10.1038/s41415-024-8166-1
DO - 10.1038/s41415-024-8166-1
M3 - Article
AN - SCOPUS:85211922243
SN - 0007-0610
JO - British Dental Journal
JF - British Dental Journal
ER -