广西壮族自治区农村小学口腔健康促进模式成本效果分析  

Cost-effectiveness analysis of the oral health promotion model in rural primary schools in Guangxi Zhuang Autonomous Region

作　　者：吴芷静 何灏逾 于雪婷 马飞[1] 刘秋林 曾晓娟[1] WU Zhijing;HE Haoyu;YU Xueting;MA Fei;LIU Qiulin;ZENG Xiaojuan(Department of Oral Health Policy Research,College&Hospital of Stomatology,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学口腔医学院·附属口腔医院口腔健康政策研究室,广西壮族自治区南宁530021

出　　处：《口腔疾病防治》2022年第5期355-360,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82060202)。

摘　　要：目的对广西壮族自治区农村小学口腔健康促进模式的防龋效果与经济学效果进行评估。方法2015年11月对项目地区农村一年级学生的患龋情况进行基线调查,随后对目标小学一年级学生进行项目干预,干预方法包括口腔保健物品发放、口腔健康教育、教师培训等。2020年采用整群随机抽样的方法,将在一年级接受项目干预且2020年仍在读的六年级学生纳入为干预组,期间外校转入未能接受项目干预的六年级学生纳入未干预组。通过分析项目干预组、未干预组共2 652名11~13岁儿童的龋病流行病学资料以评估防龋效果,采用结构分析法进行项目的成本测算,使用TreeAge pro2019建立决策树模型并纳入效果参数、成本参数进行成本效果分析与参数的敏感性分析。结果干预组患龋率54.8%,龋均1.36±1.64,均低于未干预组,两组的患龋率、龋均差异均具有统计学意义(P<0.05)。成本效果分析显示每避免1名儿童患龋花费319.83元,单因素敏感性分析显示干预组的患龋人数为经济学效果的最敏感因素,概率敏感性分析显示本项目具有成本效果优势的概率为92.2%。结论该项目的口腔健康促进模式具有良好的防龋效果和经济学效果,在广西壮族自治区内完善并推广该模式具有现实意义。Objective To evaluate the caries preventive effect and economic outcome of an oral health promotion model in rural primary schools in Guangxi Zhuang Autonomous Region. Methods In November 2015, a baseline survey was conducted on the caries prevalence of rural first graders in program areas, and then a program intervention was carried out on the first graders of target primary schools. The intervention methods included the distribution of oral health care products, oral health education, teacher training, etc. In 2020, the method of cluster random sampling was adopted to include the sixth graders who received the program intervention as first graders and were still available in2020 as the intervention group. During this period, the sixth graders transferred from foreign schools who failed to receive the program intervention as first graders were included in the non-intervention group. The caries preventive effect was evaluated by analyzing the caries epidemiological data of 2 652 children aged 11-13 years, comparing the intervention and non-intervention group. The cost of the program was estimated by the structural analysis method. A decision tree model was established by TreeAge pro2019 and incorporated into the effect parameters and cost parameters for costeffectiveness analysis and sensitivity analysis. Results The prevalence of caries in the intervention group was 54.8%,and the mean DMFT was 1.36 ± 1.64, both of which were lower than those in the non-intervention group. The difference in prevalence and mean DMFT between the two groups was statistically significant(P < 0.05). It costs CNY 319.83 per child to reduce suffering from caries. The number of patients with caries in the intervention group was the most sensitive indicator of an economic effect. The probability of a cost-effectiveness advantage for the program was 92.2%. Conclusion This oral health promotion model used in rural schools demonstrated a caries preventive effect that was very likely economically advantageous. It is of practical significance

关 键 词：龋病 口腔健康促进模式 防龋效果 成本效果 项目 小学生 农村地区 广西壮族自治区 

分 类 号：R78[医药卫生—口腔医学]