Making general anesthesia an affordable option for pediatric dental care

Making general anesthesia an affordable option for pediatric dental care

New, collaborative evidence-based guideline proposes

Anesthesia Progress — In some situations, general anesthesia is the best option for pediatric dental patients undergoing treatment. However, the cost of such services is prohibitively expensive and often inadequately reimbursed. Taking general anesthesia dental procedures out of a hospital setting and into the dental office can greatly reduce this cost.

The journal Anesthesia Progress reports a time and cost analysis of dental general anesthesia use in office and hospital settings. Data were gathered from records of 96 patients, 36-60 months in age, who received general anesthesia for dental care from either an office-like area in a school of dental medicine or a university hospital ambulatory setting in Stony Brook, New York.

For pediatric dental patients who are very young, or have severe anxiety or fear, uncooperative behavior, or physical or mental challenges, general anesthesia may be the best method of treatment. But cost and treatment time create barriers to the best care for these patients. Medicaid and health insurance programs often reimburse such procedures at a very low rate or deny benefits as being medically unnecessary.

Some of the high costs can be attributed to use of a hospital operating room and medical anesthesiologists to administer general anesthesia. This study compared cost, total anesthesia time, and recovery room time for general anesthesia use between a dental office and a hospital setting.

Findings indicated that costs were significantly reduced by administering anesthesia in a dental office. The average time of anesthesia treatment in the hospital setting was 222 minutes compared to 175 minutes in the office setting. Recovery time averaged 157 minutes in the hospital and just 25 minutes in the dental office. In the hospital setting, 2 additional hours of recovery time were required because patients must be sent to a postanesthesia care unit following surgery.

The study found an average adjusted cost savings of more than $5,000 for a dental office-based general anesthesia procedure over a hospital-based procedure. The average total cost for hospital-based care was $7,303 compared to $414 for dental office care.

Full text of “Time and Cost Analysis: Pediatric Dental Rehabilitation with General Anesthesia in the Office and the Hospital Settings,” and other articles, Anesthesia Progress, Vol. 59, No. 4, 2012, are available at www.anesthesiaprogress.org

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