Care Pathways and Health Economics
Ensuring good oral health for all is an increasingly complex challenge with key questions including how we allocate funds for different aspects of oral health, which services are the most cost-effective, what aspects of oral health the public value, how we design dental services to ensure they are accessible for all and how we should incentivise dental teams and patients to better achieve the aims of the oral health system.
We use a variety of methods including many aspects of social sciences and especially health economics to answer some of these questions. Our work is of great relevance to oral health policy makers as well as patients, dental professionals and society.
PRUDENT Project
The PRUDENT (Prioritization, incentives and Resource use for sUstainable DENTistry) project aims to develop and implement an innovative and context-adaptive framework for optimised financing of oral care across Europe.
Using a mixed-methods research approach, PRUDENT will:
- co-develop oral health system performance indicators and implement them in EU-wide monitoring framework;
- conduct real-world and lab experiments to identify improved oral care financing mechanisms;
- leverage regulatory learning, needs-adaptive resource planning and deliberative priority setting to enhance the improvement of oral care financing.
The knowledge gained will be merged into the PRUDENT Financing Companion with policy briefs and decision aid tools for concretely actionable and context-adaptive improvement of oral care financing.
Funded by EU Horizon programme/UKRI
Newcastle lead: Prof Chris Vernazza
DEEPEND Dental Project
The Deep End is a well-established series of regional networks of GP practices who provide care in areas of blanket (widespread) deprivation and allowed for better advocating for the patients. It has driven new research, focussing on the characteristics of the practices and the challenges in providing care. Many dental professionals providing care will be facing similar problems faced by GPs such as high levels of need, working under tight constraints due to potential underfunding, poor engagement with services by patients etc. This project seeks to identify the “Dentists at the Deep End” across the UK and to set up a network in our own region, the North East of England. This network will create community among professionals, provide research opportunities and improve care by providing opportunities for information sharing, learning, advocacy, and future research regarding the particular needs of those areas and new ways to address those needs.
Funded by North East and North Cumbria NIHR Clinical Research Network
Newcastle leads: Prof Chris Vernazza & Dr Sarah Sowden
FLOWAVE Project
Water fluoridation is an effective public health intervention for preventing dental caries (tooth decay). Understanding the value and cost-effectiveness of water fluoridation is crucial given the persistently high prevalence of dental caries and significant inequalities in oral health. Barriers to implementing new CWF schemes include a lack of water infrastructure, financial constraints, divergent public health priorities, legislative and procedural complexities, and a lack of political will. Economic evaluations can demonstrate the efficiency and value-for-money of CWF schemes. However, most studies to date have been cost-effectiveness analyses with limited ability to capture the full value of improved oral health. FLOWAVE (FLuOridated WAter: Public Values & Evaluation of Cost-Benefit) aims to provide a comprehensive cost-benefit analysis incorporating societal valuation of health outcomes to inform decisions about new CWF schemes.
Principal Investigator: Prof Chris Vernazza
Amalgam phase-out: what next for dentistry?
Costs and benefits of the alternative direct restorations
Dental amalgam has been used to restore posterior teeth for centuries. It contains mercury and concerns around its toxicity have mandated a phase-down of its use and an exploration of the feasibility of its phase-out in England by 2030. This thesis explored the current use of amalgam and the relative costs and benefits of the directly placed alternatives in the English NHS primary care setting, aiming to inform a potential amalgam phase-out.
Principal Investigator: Oliver Bailey
Exploring the feasibility, treatment needs and barriers to dental care of parents, children and young people accessing a mobile dental unit.
This project is addressing the oral health needs of patient who wouldn't formally access 'conventional' dental care. Using a mixed-methods research approach, this study will:
- collect data to explore the dental health of users of the bus
- screen children attending the community organisation
- undertake qualitative interviews with young people, users of the bus and dental care providers
- undertake a micro-costing exercise to ascertain the cost of providing a dental bus
The knowledge gained will be provide feasibility data for future projects, and justification for delivering care in non-health settings for those who need it most.
Lead: Dr. Greig Taylor
What do young people want to sacrifice in discrete choice experiment studies?
Discrete Choice Experiments that include a cost attribute allows a monetary measure of benefit (e.g., WTP) to be estimated indirectly for a unit change in an attribute level rather than explicitly pricing the good. Children and young people complete DCEs but often don't have the ability to understand the cost attribute, or fit their willingness to pay into their budget constraints. Children and adolescents do make rational choices, and consider time- and risk preferences which change over time, with patience and risk aversion increasing with age. Therefore, young people may still be willing to sacrifice or give up something in order to obtain the benefits from a good or service. However, it appears that a monetary sacrifice may not be the most appropriate. The aim of this study is to establish concepts that young people would be willing to sacrifice in preference elicitation studies.
This study will:
- Use qualiatiatve methods to undersand what measures of sacrifice are relevant and sensible to a range of young people
The knowledge gained will be provideconcepts of sacrifice that will be used in future contingent valuation studies.
Lead: Dr. Greig Taylor