Adequacy of the Italian National Tariff for Orthognathic Surgery: A Cost Analysis Using the Activity Based Costing (ABC) Method

The reduced economic resources in health care and the consequent spending review have brought great interest in surgical costs. The aim of the study is to determine direct hospital costs for Orthognathic procedures using the Activity based costing method and evaluate the adequacy of the refund provided by the Italian National Health Service. From January 2017 to December 2017 9 consecutive patients underwent the following Orthognathic procedures at IRCCS Casa Sollievo della Sofferenza (San Giovanni Rotondo, Italy): bimaxillary osteotomy (n = 7), Le Fort I osteotomy (n = 1) and Bilateral Sagittal Split Osteotomy (BSSO) (n = 1). Activity based costing was used to obtain costs of each single hospitalization split into surgery, instay, and services. The mean total cost for a bimaxillary osteotomy was 7596.40euro. We observed a total cost of 3925.00euro for Le Fort I osteotomy and of 4334.50euro for BSSO. The refund of 4378.00euro provided by the Italian National Health Service system for Orthognathic surgery seems insufficient to cover costs of bimaxillary osteotomy but consistent for single osteotomy (Le Fort I or BSSO).