Objectives: To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment.
Methods: A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated.
Results: The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (P<0.05). The average direct medical cost per filled tooth was significantly higher in the DGA group than in the routine outpatient group (P<0.05). The direct medical cost-filled tooth survival time ratio in the DGA group was higher than that in the routine outpatient group (P<0.05), but no significant difference was observed in the total medical cost-filled tooth survival time ratio (P>0.05).
Conclusions: Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.
目的: 对牙科全身麻醉（DGA）下和常规门诊治疗的重度低龄儿童龋（S-ECC）进行临床疗效及卫生经济学评价，为医生和家长的临床治疗方案选择提供参考。方法: 对接受DGA下牙病综合治疗或常规门诊治疗的36~71月龄S-ECC儿童进行回顾性队列研究，比较两组患儿的充填牙生存率、治疗成本以及成本—充填牙生存时间比并进行疗效和卫生经济学评价。结果: DGA组患儿充填牙生存率高于常规门诊组（P<0.05）。DGA组平均每颗充填牙的直接医疗成本、直接医疗成本—生存时间比显著高于常规门诊组（P<0.05），但两组间总医疗成本—生存时间比差异无统计学意义（P>0.05）。结论: 相比于常规门诊治疗，DGA下治疗S-ECC较常规门诊成本更高，疗效更好，二者成本—效果比相当，常规门诊治疗并不具有明显的的经济优势。.
Keywords: cost; dental general anesthesia; health economic; severe early child caries; survival analysis.