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- Title
Professional oral health care for preventing nursing home-acquired pneumonia: A cost-effectiveness and value of information analysis.
- Authors
Schwendicke, Falk; Stolpe, Michael; Müller, Frauke
- Abstract
Aim Professional oral health care (POHC) prevents nursing home-acquired pneumonia (NHAP) and its related mortality. We assessed the cost-effectiveness of POHC versus no POHC (nPOHC) and the monetary value of eliminating uncertainty by future research. Methods A German public-private payer perspective was adopted. A Markov model was used, following long-term care residents from admission to death. Cost-effectiveness was estimated as Euro/disability-adjusted life year (DALY) using Monte Carlo microsimulations. Value-of-information analyses were performed. The willingness-to-pay threshold/DALY was assumed to be 66% (range 50%-100%) of per-capita gross domestic product (GDP). Results nPOHC was less costly (€3,024) but also less effective (0.89 DALYs) than POHC (€10,249, 0.55 DALYs). For most presumed payers, POHC was cost-effective. The cost-effectiveness of POHC was higher in smokers, underweight or pulmonary disease patients. Eliminating uncertainty about the NHAP costs, NHAP incidence/mortality, and POHC effectiveness would result in an expected net value of 47 million €/year (and even higher values at lower GDP thresholds), and is likely to decrease with time. Conclusions Within the chosen setting and on the basis of current evidence, POHC was cost-effective. Given the detected uncertainty, further research seems warranted.
- Subjects
GERIATRIC dentistry; PNEUMONIA prevention; NURSING home patients; COST effectiveness; ORAL hygiene; COST of dental care; PNEUMONIA-related mortality; MEDICAL economics; DISEASES; PATIENTS; ECONOMIC history; DENTAL care; TOOTH care &; hygiene
- Publication
Journal of Clinical Periodontology, 2017, Vol 44, Issue 12, p1236
- ISSN
0303-6979
- Publication type
Article
- DOI
10.1111/jcpe.12775