Cost Savings of Primary Care Versus Hospital-Based Dental Services for the Elderly in Southern Thailand: A Client-Centered Perspective.

AIM: To evaluate the cost savings in dental services provided to elderly individuals by comparing primary care units (PCUs) and hospital-based care in Southern Thailand. METHODS: A cross-sectional study was conducted involving 322 elderly participants aged 60 years and above. Participants were recruited through multistage sampling from health facilities in three contracted units of primary care (CUPs). Data were collected via structured interviews using validated questionnaires, focusing on total client costs, including treatment, transportation, and opportunity costs. Descriptive and multilevel linear regression analyses were performed using R software, adjusting for key variables such as vehicle type, occupation, and religion. RESULTS: The mean-adjusted client cost per visit was 59 Baht at PCUs and 176 Baht at hospital settings, yielding a cost-saving of 117 Baht (3.17 USD) per visit. Transportation costs, the largest component, were significantly lower in PCUs (4 Baht) compared to hospitals (72 Baht). Sensitivity analysis over 3 fiscal years (2021-2023) demonstrated consistent cost-savings, with a maximum cumulative saving of 709,937 Baht (19,600 USD) in one CUP. Multilevel linear regression analysis revealed that the type of vehicle and client income significantly influenced total costs. PCUs provided comparable dental services with reduced geographical and economic barriers, enhancing accessibility and affordability for elderly clients. CONCLUSION: Delivering dental care at PCUs is a cost-effective alternative to hospital-based care, offering substantial financial benefits and promoting equitable healthcare access for the elderly. Policymakers should consider integrating dental services within primary healthcare frameworks to optimize resource allocation and improve health outcomes in aging populations.