تحليل هزينه اثربخشي وارنيش فلورايدتراپي دانش آموزان مدارس ابتدايي اروميه

COST EFFECTIVENESS ANALYSIS OF VARNISH FLUORIDE THERAPY OF STUDENTS IN URMIA’S PRIMARY SCHOOLS

ﭘﻴﺶﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ :ﺷﯿﻮع ﺑﺎﻻي ﺑﯿﻤﺎريﻫﺎي دﻫﺎن و دﻧﺪان و ﻫﺰﯾﻨﻪﻫﺎي ﮔﺰاف ﺗﺤﻤﯿﻠﯽ آن ﺑﺮ ﺑﯿﻤﺎر و ﻧﻈﺎم ﺳﻼﻣﺖ اﯾﻦ ﺑﯿﻤﺎريﻫﺎ را در ﺣﺎل ﺣﺎﺿﺮ ﺑﻪ ﯾﮏ ﻣﻌﻀﻞ ﻣﻬﻢ ﺳﻼﻣﺘﯽ ﻣﺒﺪل ﮐﺮده اﺳﺖ ﮐﻪ ﺗﻮﺟﻪ وﯾﮋه ﺳﯿﺎﺳﺖﮔﺬاران و ﻣﺪﯾﺮان ﻧﻈﺎم ﺳﻼﻣﺖ را ﻣﯽﻃﻠﺒﺪ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎﻫﺪف ﺗﻌﯿﯿﻦ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺸﯽ ﻣﺪاﺧﻠﻪ وارﻧﯿﺶ ﻓﻠﻮراﯾﺪ ﺗﺮاﭘﯽ اﻧﺠﺎم ﺷﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵﻫﺎ :اﯾﻦ ﭘﮋوﻫﺶ ﺑﻪﺻﻮرت ﺗﻮﺻﯿﻔﯽ ﺗﺤﻠﯿﻠﯽ ﺑﺮاي ﻣﻘﺎﯾﺴﻪ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺸﯽ دو راﻫﺒﺮد وارﻧﯿﺶ ﻓﻠﻮراﯾﺪ ﺗﺮاﭘﯽ و ﻋﺪم اﻧﺠﺎم آن در ﻣﺪارس اﺑﺘﺪاﯾﯽ ﺷﻬﺮ 1 ﮐﻞ ﺟﻤﻌﯿﺖ ﮐﻮدﮐﺎن ، اروﻣﯿﻪ و از دﯾﺪﮔﺎه اراﺋﻪدﻫﻨﺪه ﺧﺪﻣﺖ اﻧﺠﺎم ﺷﺪ. ﺟﺎﻣﻌﻪ اﯾﻦ ﭘﮋوﻫﺶ ﺳﺎل ﻣﺸﻐﻮل ﺑﻪ ﺗﺤﺼﯿﻞ در ﻣﺪارس اﺑﺘﺪاﯾﯽ اروﻣﯿﻪ ﺑﻮدﻧﺪ. ﺗﺤﻠﯿﻞ 7- 2 ﻧﺴﺒﺖ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺸﯽ ، ﺻﻮرت ﮔﺮﻓﺖ. ﺑﻌﺪ از ﺗﻌﯿﯿﻦ ﻫﺰﯾﻨﻪﻫﺎ و اﺛﺮﺑﺨﺸﯽ اﻧﺘﻈﺎري TreeAge pro 2011 دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻣﺪل درﺧﺖ ﺗﺼﻤﯿﻢﮔﯿﺮي و ﻧﺮماﻓﺰار ﺗﺤﻠﯿﻞ ﺣﺴﺎﺳﯿﺖ ﺑﺮاي ارزﯾﺎﺑﯽ ﻗﺪرت ﻧﺘﺎﯾﺞ اﻧﺠﺎم ﺷﺪ. ، ( ﻣﺤﺎﺳﺒﻪ و آﻧﺎﻟﯿﺰ ﮔﺮدﯾﺪ. ﻧﻬﺎﯾﺘﺎً ﺑﺎ ﺗﺮﺳﯿﻢ ﻧﻤﻮدار ﺗﻮرﻧﺎدو ICER) اﻓﺰاﯾﺸﯽ رﯾﺎل ﺑﻪ ازاي ﻫﺮ ﮐﺎﻟﯽ ﺑﻪ دﺳﺖ آﻣﺪ ﮐﻪ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ آﺳﺘﺎﻧﻪ ﺗﻌﺮﯾﻒ ﺷﺪه ﺗﻮﺳﻂ ﺳﺎزﻣﺎن ﺑﻬﺪاﺷﺖ ﺟﻬﺎﻧﯽ ﻣﺪاﺧﻠﻪ 12039637 ﻳﺎﻓﺘﻪﻫﺎ :ﻧﺴﺒﺖ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺸﯽ اﻓﺰاﯾﺸﯽ . رﯾﺎل ﺑﻪ ازاي ﻫﺮ ﮐﺎﻟﯽ ﻣﯽﺷﻮد 12039637 وارﻧﯿﺶ ﻓﻠﻮراﯾﺪ ﺗﺮاﭘﯽ در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺶ ﻣﯽﺑﺎﺷﺪ .ﯾﻌﻨﯽ ﻣﺪاﺧﻠﻪ وارﻧﯿﺶ ﻓﻠﻮراﯾﺪ ﺗﺮاﭘﯽ ﺑﺎﻋﺚ ﺻﺮﻓﻪﺟﻮﺋﯽ ﻫﻢﭼﻨﯿﻦ در اﯾﻦ ﭘﮋوﻫﺶ ﻧﺘﺎﯾﺞ ﻧﺴﺒﺖ ﺑﻪ ﭘﺎراﻣﺘﺮﻫﺎي ﻣﻮردﻧﻈﺮ ﺑﺮ اﺳﺎس ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ ﺣﺴﺎﺳﯿﺖ ﯾﮏﻃﺮﻓﻪ ﺣﺴﺎﺳﯿﺖ ﻧﺪاﺷﺘﻨﺪ. اﺟﺮاي ﻣﺪاﺧﻠﻪ وارﻧﯿﺶ ﻓﻠﻮراﯾﺪ ﺗﺮاﭘﯽ ﺑﻪ ﻋﻠﺖ ﮐﺎﻫﺶ ﭘﻮﺳﯿﺪﮔﯽ دﻧﺪان و ﺑﻪﺗﺒﻊ آن اﻓﺰاﯾﺶ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ اﻓﺮاد و ﻫﻤﭽﻨﯿﻦ ، ﺑﺤﺚ ﻭ ﻧﺘﻴﺠﻪﮔﻴﺮﻱ :در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺻﺮﻓﻪﺟﻮﯾﯽ ﻣﺎﻟﯽ ﺧﺎﻧﻮادهﻫﺎ در ﺑﻠﻨﺪﻣﺪت ﻧﺴﺒﺖ ﺑﻪ ﻋﺪم اﺟﺮاي ﻣﺪاﺧﻠﻪ ﻫﺰﯾﻨﻪ اﺛﺮﺑﺨﺶ ﺑﻮد. ﻧﺘﺎﯾﺞ اﯾﻦ ﭘﮋوﻫﺶ ﻣﯽﺗﻮاﻧﺪ ﺑﻪ ﺳﯿﺎﺳﺖﮔﺬاران و ﻣﺪﯾﺮان ﻧﻈﺎم ﺳﻼﻣﺖ درﺑﺎره ﻣﯿﺰان ﺗﺨﺼﯿﺺ ﻣﻨﺎﺑﻊ ﺑﺮاي ﭘﯿﺸﮕﯿﺮي از ﺑﯿﻤﺎريﻫﺎي دﻫﺎن و دﻧﺪان ﮐﻤﮏ ﮐﻨﺪ.

Background & Aims: The high prevalence of oral and dental diseases and its high cost of treatment for the patient and health system has already become an important health issue that requires special attention of policymakers and health system administrators. The aim of this study was to determine the cost effectiveness of varnish fluoride therapy intervention. Materials & Methods: This descriptive analytic study was conducted to compare the cost effectiveness of two strategies of varnish fluoride therapy and doing nothing in primary schools in Urmia and from the service provider perspective. The research population was the total number of primary school children aged 7-12 years in Urmia. After collecting the required information, data analysis was done by decision tree model and TreeAge pro 2011 software. The incremental cost effectiveness cost ratio (ICER) was calculated and analyzed after determining the expected costs and effectiveness. Finally, sensitivity analysis was performed to evaluate the power of the results by plotting the Tornado diagram. Results: The incremental cost effectiveness ratio was 12039637 Rials per QALY, varnish fluoride therapy intervention is cost effective based on the threshold defined by the WHO in this study. This means that varnish fluoride therapy can save 12039637 Rials per QALI. Also, in this study, the results were not sensitive to the chosen parameters based on results of one-sided sensitivity analysis. Conclusion: This study suggested the implementation of the varnish fluoride therapy intervention because of reduced caries and increased quality of life for individuals, as well as household savings in long run than not doing any intervention. The results of this study can also be helpful in resource allocation to prevent oral and dental illness.