Cost-minimization analysis of a tailored oral health intervention designed for immigrant older adults

Aim: This paper presents an economic evaluation, from a societal viewpoint, comparing a community-based oral health promotion program aimed at improving the gingival health of immigrant older adults, with one-on-one chairside oral hygiene instructions at a public dental clinic in Melbourne, Australia.

Methods: The costs associated with implementing and operating the oral health promotion program were identified and measured using 2008 prices. The intervention was based on the Oral Health Information Seminars/Sheets model, and consisted of 10 20-min oral hygiene group seminars and four 10-min supervised individual brushing sessions carried out by a non-oral health professional educator. Health outcomes were measured as a reduction in gingival bleeding. Clinical data showed a 75% reduction in mean gingival bleeding scores among those who took part in the intervention. A population of 100 active, independent-living older adults living in Melbourne, and members of Italian social clubs, was used for modeling in this analysis.

Results: This analysis estimated that if an oral hygiene program using the Oral Health Information Seminars/Sheets model was available to 100 older adults, the net cost from a societal perspective would be AUD$6965.20. In comparison, a standard individual oral hygiene instruction program, at public dental clinics, given equivalent levels of case complexity and assuming the same level of effectiveness, would cost AUD$40 185.00. Per participant cost of a community-based oral health promotion program was $69.65 versus $401.85 for chairside instruction.

Conclusions: Findings confirm that community-based oral health interventions are highly cost-effective and an efficient use of society's financial resources.