BACKGROUND The oral health of Indigenous children in remote communities is much worse than other population groups in Australia. Providing and maintaining an oral health service is challenging due to the remoteness of communities, the associated high cost, and the low retention of clinical staff. An annual preventive intervention delivered by fly-in clinicians may be a more cost-effective way to manage this problem. In this analysis we estimate the cost-effectiveness of an annual professional intervention for the prevention of dental caries in children of a remote Indigenous community in Far North Queensland. METHODS A cost-effectiveness analysis was conducted based on an annual preventive intervention protocol. This included treating all dental decay in those with disease, applying fissure sealants, a disinfectant swab, fluoride varnish and providing oral hygiene instructions and dietary advice to all participating school children. This study included an intervention group and a natural comparison group and both groups were followed-up for 2 years after the initial preventive intervention. A Markov model was built to assess the cost-effectiveness of the intervention compared with the usual care. Costs of treatment from the Queensland Department of Health were used and effectiveness was measured as quality-adjusted life years (QALYs) with the CHU-9D. One-way and probabilistic sensitivity analyses were conducted to identify key drivers and quantify uncertainty. RESULTS The preventive intervention was found to be highly cost-effective. The incremental cost per QALY gained was AU$3747. Probability of new caries and seeking treatment were identified as the main drivers of the model. In probabilistic sensitivity analysis intervention was cost effective in 100% of simulations. CONCLUSION An annual preventive intervention for remote Indigenous communities in Australia is a highly cost-effective strategy to prevent dental caries and improve the quality of life of children.

中文翻译：

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示范了高价值护理，以改善澳大利亚偏远土著社区的口腔健康。

背景技术偏远社区的土著儿童的口腔健康远比澳大利亚其他人口群体差。由于社区偏远，相关的高成本以及临床工作人员的保留率低，提供和维护口腔保健服务具有挑战性。飞来的临床医生提供的年度预防性干预可能是解决此问题的更具成本效益的方法。在这项分析中，我们估算了每年一次专业干预措施在昆士兰州北部偏远原住民社区预防儿童龋齿的成本效益。方法基于年度预防性干预方案进行了成本效益分析。这包括治疗患有疾病的人的所有龋齿，使用裂隙密封剂，消毒棉签，氟化物清漆，并向所有参与的在校儿童提供口腔卫生指导和饮食建议。该研究包括一个干预组和一个自然对照组，并且在最初的预防性干预之后对两组进行了为期两年的随访。建立了马尔可夫模型以评估与常规护理相比的干预措施的成本效益。使用了昆士兰州卫生部的治疗费用，并使用CHU-9D将其作为质量调整生命年（QALYs）进行了衡量。进行了单向和概率敏感性分析，以识别关键驱动因素并量化不确定性。结果发现预防性干预具有很高的成本效益。每个QALY获得的增量成本为3747澳元。新龋齿的可能性和寻求治疗被认为是该模型的主要驱动力。在概率敏感性分析中，干预在100％的模拟中具有成本效益。结论在澳大利亚偏远的土著社区，每年进行一次预防性干预，是一种预防龋齿和改善儿童生活质量的极具成本效益的策略。