Health Economic Evaluation Methods for Decision-Making in the Spanish Dental Care

Presenter: Jaime Pinilla, University of Las Palmas de Gran Canaria

Abstract

According to a recent report published by the WHO, treatment of oral diseases is extremely costly in most industrialized countries. Oral disease is the fourth most expensive diseases in these countries, where between 5 and 10% of total public health expenditures are allocated to oral health. All these facts suggest the use of economic evaluation to set oral health policies.

The main goal of the study is to conduct an economic evaluation analysis of oral health care in Spain. In particular, we will attempt to determine and specify the appropriateness for the analysis of these specific types of services methodology. The discussion and systematic review of the existing literature should allow us to perform a economic evaluation analysis and to develop and assess measures of efficacy, in terms of cost containment, of the different preventive care and other activities provided by the Spanish Autonomous Regions that have Oral Health Programs.

Oral health care continues to be a pending issue in the Spanish public health care system. The actions of the central health authority, since the incorporation of the first oral health services in the National Health Service benefits package, has evolved on impulses, never following the guidelines of an established strategy. The situation did not change with the completion of the transfer of health care competences from the central to regional health authorities. We are currently facing an unequal public provision of oral health care across the Spanish territory, a situation which on occasions, generates problems in terms of equity and efficiency. Moreover, most of the existing regional oral health programmes are quite recent and have been approved and are being implemented without previously conducting an economic evaluation or cost studies.

To summarize, we consider that in Spain, the provision of public oral health services does not aim at adapting these services to the current trends and needs in oral health, and the predominant strategy is still the provision of a standard package of services based on efficiency and effectiveness criteria. Thus, advances are made in a wrong direction. Efficiency ought to impose the principle of maximization of the quality of oral health care at the lowest possible cost. We should remember that the economic and public health approaches should tackle health problems in a similar way, given that both share a common objective -how to improve individuals’ health status and satisfaction with the services received.