Cost analysis for professional oral hygiene management of inpatients in ICU

Hospitalized patients are at an increased risk of hospital-acquired infections due to weakened immune systems. This risk is particularly high in intensive care units (ICU), where patients using mechanical ventilation face a greater likelihood of developing ventilator-associated pneumonia (VAP). Professional oral hygiene management performed by dental hygienists has been shown to reduce the risk of infections, shorten hospital stays, and lower medical costs. In Japan, a structured oral hygiene management system has been implemented for ICU patients, but South Korea lacks such a system due to the absence of dental hygiene-specific legislation and oral care insurance reimbursement codes. This study aims to provide foundational data by calculating the cost of professional oral hygiene management performed by dental hygienists through a bottom-up cost analysis after applying simulation-based training for ICU inpatients. A training program for dental hygienists was implemented to evaluate self-confidence and clinical competency in performing professional oral hygiene management for ICU patients using mechanical ventilation. A bottom-up cost analysis was applied to calculate the appropriate costs, including labor costs, material costs, and administrative costs. Statistical analysis was conducted using the SPSS software. To estimate the cost of professional oral hygiene management for ICU patients with mechanical ventilation, the performance time, labor costs, material costs, and administrative costs were analyzed by stage. The total time required for oral hygiene management was 1,040 s, and the direct labor cost for dental hygienists was calculated as 10,985 KRW. The material cost per session was 4,579 KRW, and the ICU administrative cost was 1,765 KRW. Combining these, the total cost per session of professional oral hygiene management was calculated to be 17,329 KRW. This study estimated the step-by-step costs of professional oral hygiene management performed by dental hygienists for ICU patients with mechanical ventilation, providing foundational data for calculating health insurance reimbursement rates. The significance of this study lies in being the first to analyze the costs of professional oral hygiene management using a bottom-up approach. Further research is necessary to support policies for assigning dedicated dental hygienists to ICUs and establishing reimbursement rates.