Costing analysis of the Government Assisted Populations oral health program
- 1Faculty of Dentistry, Dalhousie University
- 2School of Health Administration, Dalhousie University
Abstract
Background Refugee populations face tremendous psychological, financial, and physical health challenges due to traumatic experiences and the stresses of resettlement. Access to oral healthcare represents a significant challenge due to language barriers, cost, and lack of familiarity with the healthcare system. Robust costing analyses are necessary to inform oral health programs tailored to newly landed refugees. The purpose of this study was to estimate the costs associated with delivering the Government Assisted Populations (GAP) oral health program for refugees settling in Nova Scotia, Canada. Methods Using a bottom-up micro-costing method, we calculated the yearly direct and indirect costs associated with the delivery of oral health services via the GAP program between 2016 and 2024 from a healthcare system and societal perspectives. Direct costs consisted of the treatments rendered, and the salaries of a program coordinator and two language interpreters. Indirect costs were measured as opportunity costs. The valuation of costs was done according to published professional documents (i.e., Nova Scotia Dental Association suggested fee guide) and the current market values for goods and services. All costs were adjusted to the 2025 Canadian Dollars (CAD). Results Data from nine years of the GAP program data (2016–2024) were analyzed. The number of beneficiaries of the program/year rose from 67 patients in 2016 to 187 in 2024. The average annual treatment costs ranged from CAD 191 (SD 73) in 2016 to CAD 1,188 (SD 1,297) in 2024. The average annual productivity losses incurred by patients also rose from CAD 51 (SD 21) in 2016 to CAD 164 (SD 156) in 2024. Except for the first year, during which only hygiene services were administered, unmet needs were highest for restorative (19%-69%), preventive (13%-48%), and oral surgical (1%-10%). Total direct costs of the program ranged from CAD 53,589 in 2016 to CAD 267,622 in 2024. Over the same period, total indirect costs ranged from CAD 3,411 to CAD 30,561. Conclusions The GAP oral health program addressed substantial oral healthcare needs among refugees, with costs increasing alongside service demand. These findings provide evidence to inform resource allocation and support equitable, culturally appropriate oral healthcare programs for newly resettled refugee populations.
Related
- A patient costing analysis of Lesotho’s cervical cancer screening program
- Identifying pre-implementation barriers, facilitators and strategies for integrating a co-designed, technology-assisted parenting program within an adult mental health service
- Crisis communication strategies, government reputation signals, and health compliance willingness during COVID-19: a randomized experiment in the context of China’s zero-COVID policy
- Age differences in motivations, barriers, and facilitators of wearable and mobile app use in a government-led digital health initiative: a qualitative study
- Comparing two distinct costing models for health economics of heart failure within a Swedish population-based cohort
BibTeX
@article{ghoneim2026costing,
title = {{Costing analysis of the Government Assisted Populations oral health program}},
author = {Abdulrahman Ghoneim and Kianna Benson and Mohammad Hajizadeh and Violet D’ Souza and Heather Doucette},
journal = {BMC Health Services Research},
year = {2026},
month = jul,
doi = {10.1186/s12913-026-15149-y},
url = {https://doi.org/10.1186/s12913-026-15149-y},
note = {CC BY},
}
RIS
TY - JOUR
TI - Costing analysis of the Government Assisted Populations oral health program
AU - Abdulrahman Ghoneim
AU - Kianna Benson
AU - Mohammad Hajizadeh
AU - Violet D’ Souza
AU - Heather Doucette
PY - 2026
DA - 2026/07/01
JO - BMC Health Services Research
DO - 10.1186/s12913-026-15149-y
UR - https://doi.org/10.1186/s12913-026-15149-y
AB - Background Refugee populations face tremendous psychological, financial, and physical health challenges due to traumatic experiences and the stresses of resettlement. Access to oral healthcare represents a significant challenge due to language barriers, cost, and lack of familiarity with the healthcare system. Robust costing analyses are necessary to inform oral health programs tailored to newly landed refugees. The purpose of this study was to estimate the costs associated with delivering the Government Assisted Populations (GAP) oral health program for refugees settling in Nova Scotia, Canada. Methods Using a bottom-up micro-costing method, we calculated the yearly direct and indirect costs associated with the delivery of oral health services via the GAP program between 2016 and 2024 from a healthcare system and societal perspectives. Direct costs consisted of the treatments rendered, and the salaries of a program coordinator and two language interpreters. Indirect costs were measured as opportunity costs. The valuation of costs was done according to published professional documents (i.e., Nova Scotia Dental Association suggested fee guide) and the current market values for goods and services. All costs were adjusted to the 2025 Canadian Dollars (CAD). Results Data from nine years of the GAP program data (2016–2024) were analyzed. The number of beneficiaries of the program/year rose from 67 patients in 2016 to 187 in 2024. The average annual treatment costs ranged from CAD 191 (SD 73) in 2016 to CAD 1,188 (SD 1,297) in 2024. The average annual productivity losses incurred by patients also rose from CAD 51 (SD 21) in 2016 to CAD 164 (SD 156) in 2024. Except for the first year, during which only hygiene services were administered, unmet needs were highest for restorative (19%-69%), preventive (13%-48%), and oral surgical (1%-10%). Total direct costs of the program ranged from CAD 53,589 in 2016 to CAD 267,622 in 2024. Over the same period, total indirect costs ranged from CAD 3,411 to CAD 30,561. Conclusions The GAP oral health program addressed substantial oral healthcare needs among refugees, with costs increasing alongside service demand. These findings provide evidence to inform resource allocation and support equitable, culturally appropriate oral healthcare programs for newly resettled refugee populations.
SN - 1472-6963
ER -