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Murase M, Fujita H, Oki M, Yoshioka F, Nishiyama Y, Ohyama T, Matsumoto C, Usui S, Sato Y, Sado T, Takahashi H, Sasaki K, Matsuyama M, Sumita Y. Time-study research on maxillofacial prosthetic treatment. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:73-80. [PMID: 38298267 PMCID: PMC10828541 DOI: 10.1016/j.jdsr.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/11/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
Unreasonable medical fees can cause problems such as increased medical costs, greater medical disparities, decreased medical standards, and physician shortages. To prevent such problems, it is important to set appropriate medical fees, ensure their proper use, and improve the efficiency of medical care. The treatment of patients with maxillofacial defects is generally more expensive compared with general prosthodontic treatment because it involves more materials and requires more frequently follow-ups for longer period. However, the actual time required for maxillofacial prosthetic treatment is unclear. Therefore, in this study, we aimed to clarify the amount of time spent treating maxillofacial prosthetic patients. We analyzed clinical data from patients undergoing routine maxillofacial prosthetic treatment, irrespective of difficulty level, at 8 university hospitals and 2 dental clinics. We also collected data from maxillofacial prosthodontists on the treatment time required for various Japanese health insurance items, including the fabrication of maxillofacial prostheses. The results revealed that some aspects of maxillofacial prosthetic treatment may take longer to perform and are more costly to perform than previously thought, suggesting the need for some adjustments to the health insurance reimbursement system. Maintaining an appropriate balance between expenditures and fees will greatly benefit patients and physicians, ensuring positive health outcomes and a healthy society.
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Affiliation(s)
- Mai Murase
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Haruka Fujita
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Meiko Oki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Fumi Yoshioka
- Department of Removable Prosthodontics, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Yuichiro Nishiyama
- Tsurumi University, School of Dental Medicine, Department of Oral Rehabilitation and Prosthodontics Yokohama, Japan
| | - Tetsuo Ohyama
- Department of Partial Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Chihaya Matsumoto
- Department of Prosthetic Dentistry, School of Dentistry, Ohu University, Koriyama, Japan
| | | | - Yuji Sato
- Sato Dental Clinic, Hiroshima, Japan
| | | | - Hidekazu Takahashi
- Oral Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Miwa Matsuyama
- Department of Oral Health Care and Rehabilitation, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yuka Sumita
- Division of General Dentistry 4, The Nippon Dental University Hospital, Tokyo, Japan
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Noel OF, Dumbrava MG, Daoud D, Kammien AJ, Kauke-Navarro M, Pomahac B, Colen D. Vascularized Composite Allograft Versus Prosthetic for Reconstruction After Facial and Hand Trauma: Comparing Cost, Complications, and Long-term Outcome. Ann Plast Surg 2024; 92:100-105. [PMID: 37962243 DOI: 10.1097/sap.0000000000003731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
ABSTRACT In the past decade, vascularized composite allotransplantation (VCA) has become clinical reality for reconstruction after face and hand trauma. It offers patients the unique opportunity to regain form and function in a way that had only been achieved with traditional reconstruction or with the use of prostheses. On the other hand, prostheses for facial and hand reconstruction have continued to evolve over the years and, in many cases, represent the primary option for patients after hand and face trauma. We compared the cost, associated complications, and long-term outcomes of VCA with prostheses for reconstruction of the face and hand/upper extremity. Ultimately, VCA and prostheses represent 2 different reconstructive options with distinct benefit profiles and associated limitations and should ideally not be perceived as competing choices. Our work adds a valuable component to the general framework guiding the decision to offer VCA or prostheses for reconstruction after face and upper extremity trauma.
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Affiliation(s)
- Olivier F Noel
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | | | - Deborah Daoud
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Alexander J Kammien
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - Martin Kauke-Navarro
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - Bohdan Pomahac
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - David Colen
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
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Ali IE, Murase M, Yonehara Y, Sumita YI. Time and cost of maxillofacial prosthetic treatment: The need for assessment. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:67-68. [PMID: 35242248 PMCID: PMC8861383 DOI: 10.1016/j.jdsr.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
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