Comparison of Costs of Conventional-Mobile and Modified Dental Health Services for Primary School Children in Khlong Lan District, Kamphaeng Phet Province - เปรียบเทียบต้นทุนงานบริการทันตกรรมเชิงรุก ในโรงเรียนประถมศึกษาแบบเดิมและแบบประยุกต์ เครือข่ายบริการทันตสุขภาพ อำเภอคลองลาน จังหวัดกำแพงเพชร

Abstract

                This study aimed to compare the costs of providing four major dental activities for students by adopting two different approaches: conventional-mobile dental services at primary school and modified services which were done at a sub-district health promoting hospital by dental hygienists and to study effects of these dental services as burdens on primary schools. The cost data were collected from December 2015 to February 2016 from four primary schools in Pong Nam Ron (a sub-district of Khlong Lan District, Kamphaeng Phet Province). The activity-based cost analysis was undertaken for each activity. Cost-per-person was evaluated by employing nonparametric statistics. The results revealed that the cost of adopting conventional-mobile services approach was higher than adopting modified services approach. The proportion of labor, material and capital costs was 60.75:39.15:0.10 and 46.23:51.17:2.60 respectively. Full costs of conventional and modified services were 16,747.84 and 5,625.48 baht respectively. The differences in unit costs were 60.46 and 23.84 baht per case. Regarding cost-per-person of some dental activities, the costs for over-retained primary tooth extraction and amalgam filling in the modified services approach were significantly lower (p < 0.001). However, the differences in the profession, years of work and durable equipment used in this study were correlated with the results. Some burdens on the school under modified services were the cost of transporting students from the school to the service site. The schools under conventional- mobile services need to spend money on food and drink of the on-site dental personnel. Developing from mobile dental services to modified services at Sub-district Health Promoting hospitals had resulted in a decrease of cost-per-person for over-retained primary tooth extraction and amalgam filling. However, such approach needs to take into account the trade-off between the cost and the burdens on the school (e.g., travelling cost, road travelling safety risk, inadequate school personnel, unforeseeable school operation costs).

Key words: activity-based costing, proactive dental health service, primary schools