A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital

A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital
Published online: 13 July 2007
K. Jameson1, P. A. Averley2, P. Shackley3 & J. Steele4
British Dental Journal

Research abstract

This study is a comprehensive cost-effectiveness analysis of advanced conscious sedation techniques in primary care versus dental general anaesthetic in hospital, for children requiring dental treatment.
It is shown that the sedation techniques can be a cost-effective alternative to hospital general anaesthetic.
The ability to implement these techniques safely and cost-effectively in primary care depends on specially trained staff and dedicated facilities with a high throughput of patients.
The research further informs the debate about the best way to manage patients requiring such interventions.

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AbstractAim To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment.

Methods Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis.

Results Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was £245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of £359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters.

Conclusion The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

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Department of Economics and Related Studies, University of York
Principal Dentist, Queensway Anxiety Management Clinic, 170 Queensway, Billingham, Teesside, TS23 2NT
Senior Lecturer, Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA
Clinical Professor/Consultant, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW
Correspondence to: K. Jameson1 Mr Kevin Jameson, c/o P. Averley, Queensway Dental Practice and Anxiety Management Clinic, 170 Queensway, Billingham, Teesside, TS23 2NT
e-mail: kevin_jameson@hotmail.com

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