Abstract
Methods: 75 non-continuous patients with mandibular fractures were included retrospectively. Cases were deemed suitable for DSU if they had a Mandible Injury Severity Score < 10, and were medically/socially appropriate for DSU. Comparative cost calculations were performed for inpatient and outpatient scenarios. These included:bed-day cost, theatre time, consumables and staffing. Results: Overall average delay from admission to surgery was 0.9 days and inpatient length of stay (IPLOS) was 1.8 days. Of the seven patients assessed as suitable for DSU; mean delay to surgery was 1 day, and IPLOS 1.6 days. Cost comparison and financial savings: Inpatient and DSU theatre costs are comparable at £213.64 and £211.69 per 15mins respectively. Potential inpatient bed-day earnings are £1831. There is a premium ‘intermediate OMFS procedure’ Healthcare Resource Group tariff of £102.80 as DSU over inpatient. Conclusion: A conservative 10% of mandibular fractures can be safely managed as outpatients. This should increase as the DSU service gains experience handling more complex fractures. A business case can be made to establish a rapidaccess link to existing DSU lists to release inpatient beds in a safe manner on the basis of increased income and decreased expenditure.
Published Version
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