Cost-efficiency of a community dental delivery program for migrant children.
ABSTRACT The purpose of this study was to describe an economically efficient dental prevention and treatment program aimed at migrant children, using dental school students. This dental treatment program aimed to provide comprehensive dental care to migrant children and to provide a unique learning experience for dental students expanding their knowledge of community delivery systems.
Twenty-four dental students treated 330 migrant children through a 6-week outreach treatment program sponsored by the University of Michigan School of Dentistry, as a part of the Northwest Michigan Migrant Health Program.
The program cost $39,907 and resulted in just over $16,000 of Medicaid reimbursements. Factoring in the Medicaid reimbursements, the program cost $71.58 to treat each child comprehensively.
In light of the reported oral health disparities throughout the United States, this program provides an alternative mechanism for efficient and cost-effective oral care in a group that has traditionally had poor oral health.
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ABSTRACT: Efficiency is concerned with producing maximum output with the minimum input, although what constitutes inputs and outputs within an organization is not always clear. Labour substitution is one method of achieving efficiency gains, although cost savings are found to be context dependent and may not be achieved in some situations. Because dental therapists (DTs) in England are permitted to work in dental practices, we set out to investigate how efficiency with respect to the use of DTs is conceptualized by practitioners to deepen our understanding of the potential for substitution to realize efficiency gains in dental practice. Nine dental practices were selected using a purposive sampling methodology to give a range of practice size and DT employment arrangements. Semi-structured interviews were held with 26 dentists. Transcripts were coded and analysed thematically. Efficiency was perceived as optimum use of surgery time to generate intermediate outputs of (i) managing patient flow to give patient satisfaction and business cash flow and (ii) volume of work (procedures and numbers of patients). DT efficiency gains were evaluated according to whether lower labour costs were offset by a slower working pace and higher rate of failed appointments. Patient need and demand, and whether the practice had health improvement goals, influenced whether DTs were deemed to improve efficiency. Findings are in accord with skill mix reviews in wider health care that substitution may be effective in improving efficiency but this may be limited to particular situations where conditions are conducive. More studies are needed to explore these issues further in other dental practice contexts and with other groups of dental auxiliary.Community Dentistry And Oral Epidemiology 02/2012; 40(3):247-56. · 1.89 Impact Factor