Cost and Outcomes in Inpatient Management of Epistaxis

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.