Increasing Conscious Sedation Use for Dental Treatments: A Cost and Consequences Analysis

Speaker(s)

Chong HY1, Sivarajasingam V2, Allen M2, Dale M3
1CEDAR, Cardiff, CRF, UK, 2Cardiff Dental Hospital, Cardiff, UK, 3CEDAR, Cardiff and Vale University Health Board, Cardiff, UK

Presentation Documents

OBJECTIVES: Dental anxiety is a significant barrier to seeking dental care. In Wales, overreliance of general anaesthesia (GA) and inadequate access to conscious sedation (CS) services for these patients, has been reported to limit their access to appropriate dental care. The costs and outcomes of increasing CS use for adults undergoing a dental procedure under a new hybrid model were evaluated.

METHODS: A cost-consequence analysis comparing the new hybrid model and current practice was undertaken from an NHS perspective. Procedure costs consisted of treatment room/bed, staff and drugs. Clinical outcomes [success rate and adverse event (AE) rate], total procedure time and freed resources were included. Data were sourced from hospital theatres, finance department, published literature and expert opinion.

RESULTS: In current practice, 1,321 patients had a dental procedure under GA (n=529) or CS (n=792) from April 2022 to March 2023. It was estimated to incur £1,817,227, where GA contributed 60% of the total annual costs (£1,096,598). The estimated total procedure time was 2,956 hours with 1,161 hours in dental clinic room and 736 hours in theatre, yielding 1,297 (98%) successful cases, and 20 (1%) AE. In the new hybrid model, 130 suitable patients would move from GA to CS. The total annual costs were forecast to be £1,773,629, representing a cost-saving of £43,598, compared to current practice. This would lead to freed high-cost resource use including 107 hours of theatre time and 79 hours of Anaesthetist time. A modest change in clinical outcomes was modelled with a marginal reduction in successful cases (n=1,294, 98%) and a small increase of AEs (n=22, 2%).

CONCLUSIONS: The increased CS use in the new hybrid model potentially offers cost savings, compared to current practice. Future patient-level data collection and quality of life would improve the accuracy of the findings for economic evaluation.

Code

EE585

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Surgery