title: A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.
abstract: OBJECTIVE
  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 pound245.47. 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 pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Economics and Related Studies, University of York. kevin_jameson@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Jameson
authors.forename: P A
authors.initials: PA
authors.lastname: Averley
authors.forename: P
authors.initials: P
authors.lastname: Shackley
authors.forename: J
authors.initials: J
authors.lastname: Steele
mesh_terms: D000766:Anesthesia, Dental / Q000191:economics* / Q000379:methods; D000768:Anesthesia, General / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000191:economics*; D003365:Costs and Cost Analysis; D019140:Dental Care for Children / Q000191:economics*; D004180:Direct Service Costs; D004739:England; D005792:General Practice, Dental / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D011320:Primary Health Care / Q000191:economics