A Time-and-Motion Approach to Micro-Costing of a School-Based Fluoride Mouth Rinsing Programme
Archana Krishna Murthy,
The Oxford Dental College, Hosur Road, Bommanahalli, Bangalore, Karnataka, India.
Introduction: Fluoride mouthrinsing has been established as an effective method to prevent dental caries among school children. Time-and-motion studies help to identify the efficiency of different processes and give a comprehensive cost estimate. Economic cost of utilising teachers for fluoride mouthrinsing in schools has not been explored.
Aim: To determine the economic costs of fortnightly school-based Fluoride Mouthrinsing (FMR) program using the micro-costing technique for a period of three years.
Materials and Methods: The cost analysis study (community trial) was conducted in three government primary schools among 110 school children who were six to seven years old with high caries risk as assessed by the American Academy of Paediatric Dentistry guidelines. The school teachers were trained to carry out the FMR program by the investigator. Data on costs of resources was collected by micro-costing method using time-and-motion technique. Costs were classified as capital and recurrent costs and the total cost of the program along with unit cost were estimated.
Results: In the three years, 58 sessions of mouthrinsing were conducted with dentist being the provider for the first three sessions and the rest were provided by the teachers. The total economic cost of all inputs amounted to Indian Rupees 2,00,592.6 (US $ 3,283.0) with 95.4% from recurrent costs and only 4.6% from capital costs. The capital costs with teachers as program providers were higher than that with the dentist as program provider whereas the recurrent costs with teachers was lower than the dentist as a program provider.
Conclusion: Since the recurrent costs that make up 95% of the total costs was lower with teachers as providers than dentists, school-based FMR program using teachers can be used to provide dental services for underserved children with unmet preventive care needs.