Cost and Outcomes in Inpatient Management of Epistaxis - Abstract
Objectives: To review the cost and outcomes of conservative and surgical treatment
of epistaxis in the mean length of hospital stay, mean total hospital charges to patient
and estimated mean total hospital expenses for patient in Malaysian government
healthcare system setting, another perspective as previously published studies were
predominantly from the western countries.
Study design: Retrospective study.
Methods: The records of 65 patients admitted with a diagnosis of epistaxis (ICD10 diagnosis code R04.0) to University Malaya Medical Centre (UMMC), a tertiary
government medical centre in Malaysia from January 2002 to December 2005 were
reviewed. All patients were evaluated for age, sex, race (according to national identity
card), clinical presentation of epistaxis, possible causes of epistaxis, treatment, length
of hospital stay, total hospital charges to patient and estimated total hospital expenses
for patient.
Results: Four (6.2%) out of 65 patients failed conservative management and
proceeded with endoscopic coagulation of sphenopalatine artery to stop the bleeding
meanwhile 61 (93.8%) patients were successfully treated conservatively. The surgically
treated group had an average length of hospitalization of 5.5 days whereas the
conservatively treated group stayed an average of 3.8 days. Both of the differences
of mean total hospital charges and estimated mean total hospital expenses for
conservatively treated patients with the surgically treated group were statistically
significant by Student’s t-test with the p value <0.05.
Conclusion: Mean total hospital stay, mean total hospital charges to patient and
estimated mean total hospital expenses for patient were lower for patients who were
managed conservatively.