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Kim, Choi, and Shin: Dental implant bottom-up cost analysis
ORIGINAL ARTICLE

J Korean Acad Prosthodont 2014;52(1):18-26.

Published online: NaN January 2014

DOI: https://doi.org/10.4047/jkap.2014.52.1.18

Dental implant bottom-up cost analysis

Min-Young Kim, Ha-Na Choi, Ho-Sung Shin1, ∗

1Department of Humanities and Social Dentistry, Dental College, Wonkwang University, Iksan, Korea

2Department of Dental Hygienics, Choonhae College of Health, Ulsan, Korea

∗Corresponding Author: Ho-Sung Shin Department of Humanities and Social Dentistry, Dental College, Wonkwang University 460 Iksandaero, Iksan, 570-749, Korea +82 63 850 5995: e-mail, shinhosung@google.com

Received 20 November 201330 December 2013       Accepted 7 January 2014

Copyright © 2013 The Korean Academy of Prosthodontics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to estimate the cost of dental implant using the bottom-up approach with the current data from dental clinics.

Materials and methods

In this study, direct and indirect costs required for each treatment were calculated using the bottom-up approach. In the bottom-up costing, the average monthly total cost of dental clinic includes labor and material costs, administrative expenses, medical malpractice costs, and opportunity costs of invested capital. For the dental implant cost components, those include direct costs (labor costs, laboratory costs, material costs, depreciation or other operating costs), indirect costs (administrative costs), and the opportunity costs of investment for dental clinic.

Results

Dental implant costs of metal crown, porcelain crown and over-denture were 1,449,000 won, 1,583,000 won, and 2,471,000 won respectively. The proportion of cost components was as follows. The labor cost were 50%, and material, administrative and other cost were 33%, 15% and 2%, respectively. For direct, indirect and investment cost, the ratio were 83%, 15% and 2%, respectively.

Conclusion

The labor costs were evaluated to comprise largest proportion (about 50%, 730,000 won). Dental implant cost using Bottom-up costing was 1,450,000 won for metal crown and 1,580,000 won for porcelain crown. (J Korean Acad Prosthodont 2014;52:18-26)

Keywords: Bottom-up cost analysis, Dental implant cost, Dental implant, Procedure activity analysis

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Fig. 1.
Bottom-up and Top-down method.
jkap-52-18f1.tif
Table 1.
Average monthly labor cost by job type (Unit: person, thousand won)
  Section Average number Gross expanse Per person average expanse Monthly average expanse
Total Dentist (Government bond) 1.22 152,196 121,699 10,141
Dentist (Total income)   138,219 119,213 9,934
Dentist (Group)   130,977 117,916 9,826
Dentist (Mean)   140,464 119,609 9,967
Dental hygienist 1.94 46,814 24,131 2,011
Nurse's aide 1.08 23,450 21,713 1,809
Other 0.67 10,178 15,191 1,266

note: ∗ Shin Young Seok et al. Accounting Survey of Dental Institutions to Improve Relative Value by Type of Dental Practice. National Health Insurance Corporation Korea Institute for Health and Social Affairs policy report 2012.

Table 2.
Labor cost per minute
Content Value
Average annual workdays (49 weeks × 5.5 days) 269.5 days
Average monthly working days (269.5/12 months) 22.46 days
Average monthly working hours (22.46 × 6.81 hours × 60 minute) 9,177 minute
Labor cost per minute Average monthly labor cost / 9,177 minute

note: ∗ Shin Ho Sung et al. Establishment of a Rational Dentistry Delivery System. Korea Institute for Health and Social Affairs policy report 2009.

Table 3.
Total times required for surgical procedures, implant prosthesis an follow-up management
Prosthesis of dental implant Time required for treatment
Metal crown 499.8 minute
Porcelain crown 574.4 minute
Over-denture 828.4 minute

note: ∗ Shin Ho Sung et al. Dental implant cost analysis. Korea Institute for Healt and Social Affairs policy report 2008.

Table 4.
Average numbers of dental implants treated per dental clinic in 2008
Time Average numbers of dental implants
Monthly 17.89
Annual 215
Table 5.
Laboratory cost for a dental implant (Unit: won)
Area Cast crown Porcelain crown Attachment Overdenture
Seoul 187,000 196,000 147,000 579,000
Metropolitan 77,000 82,000 350,000 798,000
Small and medium-sized cities 173,000 198,000 193,000 465,000
County 105,000 110,000 150,000 330,000
Average 167,000 184,000 195,000 527,000

note: ∗ Shin Ho Sung et al. Dental implant cost analysis. Korea Institute for Health and Social Affairs policy report 2008.

Table 6.
Annual mean administrative cost and allocation method (Unit: The number, thousand won, %)
Cost Sample Sum Proportion Allocation method
Welfare cost 36 18,385 11.23 Proportion of activity time
Travel cost 36 2,393 1.46 Proportion of activity time
Tax and public dues 36 4,219 2.58 Profit proportion
Payment rent 36 22,717 13.87 Proportion of activity time
Depreciation cost 36 23,276 14.21 Profit proportion
Repairing expense 36 1,214 0.74 Proportion of activity time
Insurance 36 3,842 2.35 Proportion of activity time
Entertainment expenses 36 7,513 4.59 Proportion of activity times
Advertising expense 36 2,079 1.27 Profit proportion
Transportation cost 36 557 0.34 Proportion of activity times
Vehicles Maintenance Expenses 36 5,342 3.26 Proportion of activity times
Payment commission 36 19,951 12.18 Proportion of activity times
Selling concession 36 112 0.07 Proportion of activity times
Bad debts expense 36 2,805 1.71 Profit proportion
Supplies expense 36 11,489 7.02 Profit proportion
laboratory cost 36 21,576 13.17 Profit proportion
laboratory materials cost 36 - 0.00 Profit proportion
Others 36 4,806 2.93 Proportion of activity times
Interest paid and Discount rate 36 - 0.00 Proportion of activity times
Contribution 36 - 0.00 Proportion of activity times
Communication expense 36 2,133 1.3 Proportion of activity times
Electricity cost 36 3,745 2.29 Proportion of activity times
Environment management cost 36 - 0.00 Equal distribution
Publication Expenses 36 1,458 0.89 Equal distribution
Festivity 36 - 0.00 Equal distribution
Fuel charge 36 - 0.00 Equal distribution
Missionary work 36 - 0.00 Equal distribution
Medical expense 36 - 0.00 Equal distribution
Clothes and beddings 36 - 0.00 Equal distribution
Outsourcing service 36 - 0.00 Profit proportion
Building maintenance expense 36 4,154 2.54 Proportion of activity time
Total 36 163,776 100  

note: ∗ Shin Young Seok et al. Accounting Survey of Medical Institutions to Improve Relative Value by Type of Medical Practice. National Health Insurance Corporation/Korea Institute for Health and Social Affairs policy report 2012.

Jung Yong Mo. Case study on Activity-Based Costing for a Hospital. Health services administration, Graduate school of public health Inje university. 2004.

Table 7.
Dental implant bottom-up cost (Unit: won)
  Item Metal crown Porcelain crown Overdenture
Total labor costs   730,751 847,500 1,197,635
Material costs Direct material costs 1∗ 192,000 192,000 192,000
Indirect material costs 2∗∗ 72,579 72,579 72,579
laboratory cost ∗∗∗ 167,000 184,000 722,000
Direct mechanism depreciation 24,279 24,279 24,279
Common mechanism depreciation 24,490 24,490 24,490
Administrative expenses   218,948 218,948 218,948
Medical malpractice cost   7,138 7,138 7,138
Cost of capital   12,091 12,091 12,091
Total   1,449,276 1,583,025 2,471,160

∗ material costs of fixtures, abutments, healing caps for dental implant, ∗∗ consumable material costs for dental implant practice, ∗∗∗ overdenture laboratory costs include attachment costs.

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