Cost analysis of orthognathic surgery: outpatient care versus inpatient care

C Pekkari; B Lund; T Davidson; A Naimi-Akbar; A Marcusson; C K Weiner

doi:10.1016/j.ijom.2024.02.005

Cost analysis of orthognathic surgery: outpatient care versus inpatient care

Int J Oral Maxillofac Surg. 2024 Feb 29:S0901-5027(24)00053-5. doi: 10.1016/j.ijom.2024.02.005. Online ahead of print.

Authors

C Pekkari¹, B Lund², T Davidson³, A Naimi-Akbar⁴, A Marcusson⁵, C K Weiner⁶

Affiliations

¹ Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Eastman Institute, Folktandvården Stockholm AB, Stockholm, Sweden. Electronic address: carina.pekkari@ki.se.
² Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
³ Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden.
⁴ Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Eastman Institute, Folktandvården Stockholm AB, Stockholm, Sweden; Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden.
⁵ Maxillofacial Unit in Linköping, and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
⁶ Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Gävle Hospital, Folktandvården Gävleborg, Gävleborg, Sweden.

PMID: 38429199
DOI: 10.1016/j.ijom.2024.02.005

Abstract

With limited healthcare resources, it is important to provide the right level and form of care. The aim of this study was to determine whether selected single-jaw orthognathic surgery in outpatient care (OPC) generates lower healthcare costs than in inpatient care (IPC). The costs of surgically assisted rapid maxillary expansion (SARME), Le Fort I osteotomy (LFI), and bilateral sagittal split osteotomy (BSSO) were calculated for 165 patients, 107 treated in OPC and 58 in IPC. Additionally, costs for revisits, emergency visits, emergency phone calls, re-operations, and plate removal during the first 12 months postoperatively were recorded. The total mean costs of the different operations including revisits, emergency visits, and phone calls were 34.2-48.8% lower in OPC than in IPC at 12 months postoperatively. Operation costs were lower for LFI in OPC (P = 0.009) and for SARME in IPC (P = 0.007). Anaesthesia costs were lower for LFI (P < 0.001) and BSSO (P < 0.001) in OPC, and there were fewer revisits (P = 0.001) and lower costs (P = 0.002) after LFI in OPC compared to IPC. This study showed that selected single-jaw orthognathic surgeries in outpatient care are associated with lower healthcare costs compared to inpatient care.

Keywords: Cost comparison; Cost measures; Cost minimization analysis; Costs and cost analysis; Day care; Inpatients; Orthognathic surgery; Outpatient care.