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The European Journal of Orthodontics Advance Access originally published online on October 14, 2008
The European Journal of Orthodontics 2009 31(1):90-94; doi:10.1093/ejo/cjn040
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© The Author 2008. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

An exploratory study of the cost-effectiveness of orthodontic care in seven European countries

Jamie Deans, Rebecca Playle, Peter Durning and Stephen Richmond

Department of Dental Health and Biological Sciences, Cardiff University Dental Hospital, UK

Address for correspondence Professor Stephen Richmond, Department of Dental Health and Biological Sciences, Cardiff University Dental Hospital, Heath Park, Cardiff CF14 4XY, UK, E-mail: richmonds{at}cardiff.ac.uk


  Abstract

This study investigated the orthodontic treatment of 429 consecutive patients [172 male (40.1 per cent) and 257 female (59.9 per cent)] carried out by 10 orthodontic specialist practitioners in seven European countries [two in the Czech Republic (A and B), two in Germany (A and B), Italy, Latvia, Lithuania, and Netherlands, and two in Slovenia (A and B)]. The median age of the patients at the start of treatment was 13.0 years (minimum 7.3 years maximum 50.3 years). The patients had a range of malocclusions and the majority (97 per cent) were treated with upper and lower fixed appliances.

Real exchange rates were calculated using purchasing power parity (PPP) indicators to allow cross-border comparisons of costs. The Index of Complexity, Outcome and Need (ICON) was used to measure the effectiveness of treatment and cost per ICON point reduction to compare cost-effectiveness of orthodontic treatment between practitioners in different European countries.

The median cost per ICON point reduction for all the cases treated was {euro}57.69. The median cost per ICON point reduction varied greatly between practitioners from {euro}21.70 (Lithuania) to {euro}116.62 (Slovenia A). Analysis of variance and Tukey post hoc tests showed the differences in cost-effectiveness between the practitioners to be statistically significant (P < 0.001).

The cost per ICON point reduction is a simple and effective method of comparing cost-effectiveness between orthodontic practitioners in different countries.


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