Cost-effectiveness study of a school-based sealant program

A nonprofit private dental clinic provides free dental treatment for childr en up to the age of eighteen years. In order to expand its services to reac h more children, a school-based sealant program using dental auxiliary pers onnel was organized. This paper evaluated the performance of the school-bas ed program during 1991 by comparing the costs of the school-based program w ith the costs of the sealants placed in the clinic in twelve months. Costs were calculated based on 1991 expenditures, and effectiveness rates were es timated from dental Literature on sealants. The cost of saving one tooth-su rface from decaying within a six-year period at the school and the clinic w as $65 and $42 with Bn average sealing time per tooth surface of 18 and 12. 5 minutes, respectively. Despite the relatively lower cost of personnel, th e school program cost was 35 percent higher than at the clinic. Nevertheles s, if hidden costs, such as transportation, time off work, and waiting time for those attending the clinic were considered, costs could be comparable or even higher for the clinic. The main goal of this paper is to explore a methodology to compare programs of different nature, and critically evaluat e the results.