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Oshima K. People's Willingness to Pay for Dental Checkups and the Associated Individual Characteristics: A Nationwide Web-Based Survey among Japanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4145. [PMID: 36901149 PMCID: PMC10001831 DOI: 10.3390/ijerph20054145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to determine the willingness-to-pay (WTP) values for dental checkups and analyze the association between the values and individual characteristics. This cross-sectional study was conducted using a nationwide web-based survey, and 3336 participants were allocated into groups that received regular dental checkups (RDC; n = 1785) and those who did not (non-RDC; n = 1551). There was a statistically significant difference in the WTP value for dental checkups between the RDC (median: 3000 yen [22.51 USD]) and non-RDC groups (2000 yen [15.01 USD]). In the RDC group, age 50-59 years, household income <2 million yen, homemaker and part-time worker employment status, and having children were significantly associated with decreased WTP values; male sex, household incomes ≥8 million yen, and tooth brushing ≥3 times daily were associated with increased WTP values. In the non-RDC group, age ≥30 years, household incomes <4 million yen, and having ≥28 teeth were significantly associated with decreased WTP values; household income ≥8 million yen was associated with increased WTP values. Conclusively, WTP values for dental checkups were lower in the non-RDC group than in the RDC group; in the non-RDC group, those with lower household income aged ≥30 years were more likely to propose lower WTP values, suggesting the need for policy intervention to improve access to RDC.
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Affiliation(s)
- Katsuo Oshima
- Department of Dental Technology, The Nippon Dental University College, Tokyo 102-8159, Japan
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Zhurakivska K, Luciano R, Caponio VCA, Lo Russo L, Muzio LL, Mascitti M, Troiano G. Cost/effectiveness analysis of treatment options for the rehabilitation of the total edentulous mandible. J Oral Rehabil 2023; 50:400-409. [PMID: 36704998 DOI: 10.1111/joor.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Several solutions are available for the rehabilitation of edentulous jaws. Each treatment option is characterised by specific advantages and drawbacks. OBJECTIVE The aim of this research was to perform a cost-effectiveness (CE) analysis of the main rehabilitative solutions of totally edentulous mandibles. METHODS Decision tree models were built using TreeAge Pro Healthcare 2021 software to compare the following strategies: Conventional Denture (CD), Overdenture retained by two implants (OD-2), Overdenture retained by a bar on two implants (ODbar), Overdenture retained by 4 mini-implants (ODmini) and Fixed denture supported by 4 implants (FD). Costs were estimated using data from public rate tables. Effectiveness measures were obtained from a meta-analysis of literature data, normalising the different scales in 0-1 range. A value of 30 000€ per 1 normalised utility points was set as threshold of willingness to pay (WTP). Probabilistic sensitivity analysis (PSA) with 1000 Monte Carlo Simulations was performed to characterise uncertainty. RESULTS Total costs ranged between 1804,40€ for CD and 10 008,80€ for FD rehabilitations, with an effectiveness of 0,69 and 0,95 normalised points (0-1 scale) for the two solutions. The ODbar resulted to be the most CE strategy at the established WTP value, with the highest Net Monetary Benefit (22 001,20€), followed by the OD-2 rehabilitation (21 866,80€). PSA analysis confirmed the dominance of OD-2 and ODbar strategies, confirming a net separation from the other alternatives. CONCLUSION OD stabilised by 2 implants could represent a good rehabilitative solution for patients with edentulous mandible, being a good trade-off in terms of costs and effectiveness. Nevertheless, a standardised measure of oral health-related quality of life is needed to obtain more reliable results.
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Affiliation(s)
- Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rossella Luciano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Van de Winkel T, Heijens L, Listl S, Meijer G. What is the evidence on the added value of implant-supported overdentures? A review. Clin Implant Dent Relat Res 2021; 23:644-656. [PMID: 34268866 PMCID: PMC8457103 DOI: 10.1111/cid.13027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 12/02/2022]
Abstract
Background Implant‐supported overdentures (IODs) have been reported to increase patients' oral health‐related quality of life (OHRQoL) in comparison with conventional dentures (CDs); however, the conclusiveness of evidence on the clinical effectiveness and value for money of IODs versus CDs remains unclear. Purpose To review how the added value of IODs is demonstrated in the literature. Materials and methods MEDLINE, EMBASE, and the Cochrane Database were searched for randomized control trials, controlled clinical trials, and prospective cohort studies containing evaluations of the economic and health benefits and costs of IODs. Information about the clinical effectiveness, such as magnitude of bite forces or chewing efficacy, OHRQoL, costs, and cost‐effectiveness of IODs, was extracted. Results A total of 17 articles were included, reporting 15 economic evaluations: 11 cost‐utility analyses (CUAs), 2 of which were combined with a cost‐effectiveness analysis (CEA), and 2 cost–benefit analyses (CBAs). Seven CUAs used the Oral Health Impact Profile (OHIP) questionnaire while four used satisfaction questionnaires to assess the OHRQoL. One study applied quality‐adjusted prosthesis years (QAPYs) for this purpose. The CBAs expressed both the beneficial outcome and the costs of the IOD in monetary terms. The included studies employed a large variety of economic evaluation methods, which limited cross‐study comparability. Conclusions On the basis of existing economic evaluations, IODs have frequently been suggested to be a cost‐efficient treatment alternative to CDs; however, the comparability between the various economic evaluation studies was limited due to the different outcome measures used. In addition, it remains unclear whether the additional health benefits of IODs outweigh the higher costs. This is largely dependent on the decision maker's valuation of oral health outcomes. Future research is encouraged to further elucidate patient willingness to pay for IODs and the societal return on investing in IODs more generally.
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Affiliation(s)
- Thomas Van de Winkel
- Department of Oral Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Laura Heijens
- Department of Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany
| | - Gert Meijer
- Department of Oral Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
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Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147219. [PMID: 34299670 PMCID: PMC8307611 DOI: 10.3390/ijerph18147219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/26/2022]
Abstract
Background: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. Methods: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. Results: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. Conclusions: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions.
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Tada S, Kanazawa M, Miyayasu A, Iwaki M, Srinivasan M, Minakuchi S, McKenna G. Patient preferences for different tooth replacement strategies for the edentulous mandible: A willingness-to-pay analysis. J Prosthodont Res 2021; 65:535-540. [PMID: 33980785 DOI: 10.2186/jpr.jpr_d_20_00170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of this study was to evaluate patients' economic preferences for two different tooth replacement strategies for the edentulous mandible namely conventional complete dentures (CCDs) and implant overdentures supported by two implants (IODs), using a willingness-to-pay (WTP) analysis. METHODS Twenty-six elderly patients who had been rehabilitated with either a mandibular CCD or IOD were invited to participate in this study. All participants were provided with the details of the two treatment protocols, including advantages, disadvantages, and treatment costs. The patients were then asked to indicate their maximum WTP values for each protocol using a payment card method for contingency evaluation. RESULTS Fifteen patients with mandibular CCD (CCD-Group) and 12 patients with IOD (IOD-Group) participated in the study. Overall, the median and maximum WTP values recorded for IOD therapy were significantly higher than those for CCD therapy (p<0.05). Both treatment groups recorded maximum WTP values for CCD therapy, which exceeded the market cost (¥30,000 [US$280]), CCD-Group: ¥50,000 (interquartile range [IQR]: 40,000 - 65,000), and IOD-Group: ¥45,000 (IQR: 30,000-85,000)]. However, both groups registered a median and maximum WTP values for IOD therapy lower than the market cost (¥780,000 [US$7,300]), (CCD-Group: ¥500,000 [IQR: 300,000 - 750,000], IOD-Group: ¥700,000 [IQR: 500,000-800,000]). CONCLUSION The maximum WTP values recorded for IOD therapy were significantly higher than CCD therapy in both treatment groups. While patients were willing to pay more than the current market costs for CCDs, they were not willing to meet the market value for IODs.
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Affiliation(s)
- Sayaka Tada
- Discipline of Endodontics, Restorative Dentistry and Prosthodontics, Discipline of Primary Dental Care & Population Health, Faculty of Dentistry, National University of Singapore
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Maiko Iwaki
- General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Murali Srinivasan
- Clinic of General-, Special care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Gerald McKenna
- Centre for Public Health, Institute for Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast
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Saadatfar N, Jadidfard MP. An overview of the methodological aspects and policy implications of willingness-to-pay studies in oral health: a scoping review of existing literature. BMC Oral Health 2020; 20:323. [PMID: 33183293 PMCID: PMC7664028 DOI: 10.1186/s12903-020-01303-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/29/2020] [Indexed: 11/25/2022] Open
Abstract
Background Demands for dental services seem to be beyond the capacities of most healthcare systems these days. Patient preferences have been increasingly emphasized to be considered in the joint decision-making process. Willingness-to-pay (WTP) is a recommended method for measuring the utility of health services; increasingly being used in recent decades. Taking these points into consideration, this article aims to provide an overview of the methodological aspects and policy implications of WTP studies in the field of oral health. Methods The research was conducted in ISPOR, PubMed and Google Scholar databases. In addition, reference lists of included articles were checked to identify the relevant studies. All studies published were included that were in the English language and reported using WTP for oral health-related goods and services. A data-charting form was developed by a focus group discussion panel of seven experts to derive the main methodological aspects of WTP. Also, Core policy suggestions were categorized through thematic content analysis of the included papers. Results The search strategy yielded 389 studies of which 52 were included. WTP studies in oral health show an increasing trend in global publications. The UK and Canada have a greater share in published material than in any other country. The dominant field of these researches is in restorative and prosthetic dentistry, and a wide range of different methodological aspects was documented. Policy suggestions were categorized in three main themes: (A) setting new tariffs or subsidizing the item, (B) provision of the item due to population preferences, and (C) improving literacy regarding the item. Conclusions An urgent need for a common framework regarding the design of WTP studies in dentistry seems paramount. Some policy suggestions seem not to be applicable, perhaps due to insufficient familiarity of the researchers with the complexities of the public policymaking process.
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Affiliation(s)
- Navid Saadatfar
- Department of Community Oral Health, School of Dentistry, Shahid-Beheshti University of Medical Sciences, Shahid-Chamran Avenue, Evin, Tehran, 19839, Iran
| | - Mohammad Pooyan Jadidfard
- Department of Community Oral Health, School of Dentistry, Shahid-Beheshti University of Medical Sciences, Shahid-Chamran Avenue, Evin, Tehran, 19839, Iran.
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Bouhy A, Rompen E, Lamy M, Legros C, Lecloux G, Lambert F. Maxillary implant overdenture retained by four unsplinted attachments and opposed by a natural or fixed dentition: One-year clinical outcomes. Clin Oral Implants Res 2020; 31:747-767. [PMID: 32497274 DOI: 10.1111/clr.13623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/14/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this prospective study was to evaluate the implant, prosthesis, and patient-reported outcomes of maxillary removable prostheses retained by 4 implant-supported study abutments after a follow-up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible. MATERIALS AND METHODS A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow-up period of 1 year. Patient-reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP-20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS). RESULTS A single patient dropped out. At the post-operative 12-week follow-up, 79.3% (95% CI: 64.6%-94.1%) of the patients displayed peri-implant mucosa hyperplasia and 69.0% (95% CI: 52.1%-85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%-92.5%), and the mean peri-implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85-1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%-99.9%). The OHIP-20 and VAS scores both improved significantly from baseline to 1 year (p < .001). CONCLUSION The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures.
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Affiliation(s)
- Alice Bouhy
- Department of Removable Prosthodontics, University of Liège, Liège, Belgium
| | - Eric Rompen
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium
| | - Marc Lamy
- Department of Removable Prosthodontics, University of Liège, Liège, Belgium
| | - Caroline Legros
- Department of Removable Prosthodontics, Faculty of Medicine, University of Liege, Liège, Belgium
| | - Geoffrey Lecloux
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium
| | - France Lambert
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium
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Ioannidou E, Feine J. Oral Health Is About More Than Clean Teeth. JDR Clin Trans Res 2020; 5:4-5. [DOI: 10.1177/2380084419891431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- E. Ioannidou
- Faculty of Dentistry, University of Connecticut, Oral Health and Diagnostic Sciences, UConn Health, Farmington, CT, USA
| | - J.S. Feine
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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