Dental casemix computer program for basic dental procedure reimbursement

Reimbursement system  is important for budget allocation, especially in the government service units. Nowadays, there is no specific computer program for dental procedure reimbursement. In general healthcare system, the well-known computer program is the casemix, especially Diagnosis-related Group (DRG) program. However, the DRG is used in In-patient Department, so its parameters are not suitable for dentistry. Objective: to evaluate Dental Casemix Computer Program (DCCP) for reimbursement of basic dental procedures using different code set.  Methods: DCCP was developed based on Access Program. Code set for extraction and filling based on Current Dental Terminologies (CDT), but the periodontal code was designated according to the complexity of each case. ICD-9-CM procedural code in each case was also collected and compared. The capital, labor and material costs in each patient receiving dental treatment at Thammasat University Dental Student Clinic in June, 2013 was collected and analyzed to find which code set could reflect and differentiate unit cost. Results: Total number of the recruited patients was 318. Unit costs of extraction/impaction surgical removal ranged from 28.48-38.07US$. Unit costs of filling ranged from 27.27-28.56US$. Unit costs of scaling/root planing ranged from 36.95-153.15US$. No difference of extraction/filling unit costs could be demonstrated using different code set, whereas the different unit costs in scaling/root planing depended on complexity of cases and number of visits. Capital, labor and material costs in each case ranged from 22.23-22.44, 3.00-3.45, and 1.72-2.84US$ respectively. Conclusion: Because of high capital and labor costs, dental unit costs did not depend on difficulty of surgical procedures, filling materials and numbers of filling sides. The complexities of periodontal treatment affected chair time, as well as unit costs. DCCP should be further evaluated in other settings, such as public health service and private practice because of different settings from this research.