Oral healthcare delivery in institutionalised older people : a health‐economic evaluation

Objectives This health-economic evaluation aimed to assess the cost-effectiveness of a number of alternatives for preventive and curative oral health care in institutionalised older people in Flanders. Methods A six-state Markov model was used to compare expected costs and healthy oral years (HOYs) of four alternatives: (1) usual care; (2) on-site preventive care; (3) on-site preventive care + curative care in the community; and (4) on-site preventive care + on-site curative care. A healthcare payer perspective was adopted, and the time horizon was 10 years. Deterministic and probabilistic sensitivity analyses were performed. Results Incremental cost-effectiveness ratios (ICERs) of alternatives 2, 3 and 4 (all compared to alternative 1) were as follows: (2) 7944 euro/HOY gained; (3) 1576 euro/HOY gained; and (4) 1132 euro/HOY gained. Hence, alternatives 2 and 3 were not cost-effective compared to alternative 4. The probability that oral care interventions are more effective and cost-saving than usual care was