title: Combining procedures under general anesthesia.
abstract: OBJECTIVE
  The purpose of this study was to analyze cases in which dentistry was combined with other procedures during a single outpatient general anesthetic (GA) in a children's hospital. Financial and time savings were evaluated for a subgroup of combined care patients.
  
  
  METHODS
  Records of 120 patients who received combined dental and one other procedure under GA were reviewed. All were treated as outpatients, and dental procedures were more than just radiographs. Descriptive statistics were calculated for: (1) patient characteristics; (2) procedures; (3) times for procedures; (4) anesthesia; (5) recovery; and (6) total time in hospital. Records of 18 patients with combined dentistry and extraction of third molars were compared to 36 patients receiving the same procedures during separate GAs to evaluate time and costs for combined vs separate procedures.
  
  
  RESULTS
  Patients ranged from 2 to 21 years, and 98% had special health care needs. Oral surgery (41%) and otolaryngology (23%) were most frequently combined with dentistry. Estimated mean savings for patients receiving dentistry and third molar extractions in combination were 312 minutes and $2,177.
  
  
  CONCLUSIONS
  Combining care offers an economical vehicle for providing medical and dental care to patients needing multiple procedures. Awareness of the efficiency of combined care may lead to more combinations of procedures when possible.
authors.affiliation: Children's Hospital and Regional Medical Center, Seattle, Wash., USA. stapletonmf@hotmail.com
authors.forename: Mark
authors.initials: M
authors.lastname: Stapleton
authors.forename: Barbara
authors.initials: B
authors.lastname: Sheller
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Williams
authors.forename: Lloyd
authors.initials: L
authors.lastname: Mancl
mesh_terms: D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003730:Dental Care for Persons with Disabilities; D003953:Diagnosis-Related Groups; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007902:Length of Stay; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D013997:Time Factors; D014081:Tooth Extraction