Abstract:
Objectives: To create an evidence‐based research tool to inform and guide policy and program
managers as they develop and deploy new service delivery models for oral disease prevention and
intervention.
Methods: A village‐level discrete event simulation was developed to project outcomes
associated with different service delivery patterns. Evidence‐ based outcomes were associated with
dental health aide activities, and projected indicators (DMFT, F+ST, T‐health, SiC, CPI, ECC) were proxy
for oral health outcomes. Model runs representing the planned program implementation, a more
intensive staffing scenario, and a more robust prevention scenario, generated 20‐year projections of
clinical indicators; graphs and tallies were analyzed for trends and differences.
Results: Outcomes associated with alternative patterns of service delivery indicate there is
potential for substantial improvement in clinical outcomes with modest program changes. Not all
segments of the population derive equal benefit when program variables are altered. Children benefit
more from increased prevention, while adults benefit more from intensive staffing.
Conclusions: Evidence‐ based simulation is a useful tool to analyze the impact of changing
program variables on program outcome measures. This simulation informs dental managers of the
clinical outcomes associated with policy and service delivery variables. Simulation tools can assist public
health managers in analyzing and understanding the relationship between their policy decisions and
long‐term clinical outcomes.