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Outpatient Alveolar Bone Grafting.

Scott J Farber1, Christopher M Runyan, Marleigh J Stern

  • 1*Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO †Hansjörg Wyss Department of Plastic Surgery, NYU School of Medicine, New York, NY.

The Journal of Craniofacial Surgery
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Summary

Outpatient alveolar bone graft (ABG) surgery using the Acumed trephine technique significantly reduces costs compared to inpatient procedures. This approach enables same-day discharge, offering a safe and cost-effective alternative.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Surgical Cost Analysis
  • Bone Grafting Procedures

Background:

  • Alveolar bone graft (ABG) traditionally requires inpatient stay due to donor site pain.
  • The Acumed trephine technique has shown potential to reduce donor site pain and enable outpatient procedures.

Purpose of the Study:

  • To examine the cost savings associated with outpatient ABG surgery.
  • To compare the costs of inpatient, observation, and outpatient ABG procedures.

Main Methods:

  • Retrospective review of 62 ABG procedures from 2012-2015.
  • Categorization of patients into inpatient, observation (23-hour), or outpatient groups.
  • Analysis of direct costs, variable direct costs, fixed direct costs, and supply/OR costs using t tests.

Main Results:

  • Average total direct costs were $4536 (inpatient), $3222 (observation), and $3340 (outpatient).
  • Inpatient costs were significantly higher than outpatient costs (P<0.01).
  • Outpatient/observation groups had significantly lower variable and fixed direct costs.

Conclusions:

  • Inpatient stays for ABG are significantly more expensive than outpatient or 23-hour observation.
  • The Acumed trephine technique facilitates same-day discharge for ABG.
  • Outpatient ABG offers a safe and cost-efficient treatment option amid declining reimbursement.