ORCID
- Robert Witton: 0000-0002-6424-4376
- Lyndsey Withers: 0000-0002-0027-2626
- Martha Paisi: 0000-0001-5718-008X
Abstract
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.
Publication Date
2024-12-12
Publication Title
British Dental Journal
ISSN
0007-0610
Recommended Citation
Nguyen, T., Witton, R., Withers, L., & Paisi, M. (2024) 'Economic evaluation of a community dental care model for people experiencing homelessness', British Dental Journal, . Available at: 10.1038/s41415-024-8166-1