Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

Figures & data

Table 1 Descriptive data on patients who sustained facial injuries alone and facial injuries with other injuries

Sample characteristics	Total, n (%)	Facial injuries with other injuries, n (%)	Facial injuries alone, n (%)	P-value
Total patients	190 (100)	107 (100)	83 (100)
Age, years, mean (SD)	28 (15.3)	27.6 (15.4)	28.5 (15.4)	0.358*
Age-group
<16 years	15 (7.9)	6 (5.6)	9 (10.8)
16–25 years	99 (52.1)	64 (59.8)	35 (42.2)	0.071**
26–40 years	41 (21.6)	18 (16.8)	23 (27.7)
>40 years	35 (18.4)	19 (17.8)	16 (19.3)
Sex
Male	158 (83.2)	86 (80.4)	72 (86.7)	0.244**
Female	32 (16.8)	21 (19.6)	11 (13.3)
Education
No formal education	14 (7.4)	9 (8.4)	5 (6)
Primary	8 (4.2)	4 (3.7)	4 (4.8)	0.048***
Secondary	149 (78.4)	78 (72.9)	71 (85.5)
Tertiary	19 (10)	16 (15)	3 (3.6)
ISS, mean (SD)	5.4 (4.2)	8.1 (6.2)	1.9 (1.7)	<0.001*
ISS categories
Mild (0–9)	160 (84.2)	78 (72.9)	82 (98.8)
Moderate (10–15)	18 (9.5)	17 (15.9)	1 (1.2)	<0.001***
Severe (16–25)	10 (5.3)	10 (9.3)	0
Very severe (>25)	2 (1.1)	2 (1.9)	0
GCS on ED arrival
Mild (15–13)	171 (90)	91 (85)	80 (96.4)
Moderate (8–12)	6 (3.2)	6 (5.6)	0	0.016***
Severe (3–7)	5 (2.6)	5 (4.7)	0
Unknown	8 (4.2)	5 (4.7)	3 (3.6)
Discharge outcome	181 (95.3)	98 (91.6)	83 (100)
Discharge home	9 (4.7)	9 (8.4)	0
Transfer to other ward				0.005***

Notes:

* Student’s t-test;

** Pearson’s χ²;

*** Fisher’s exact test. Data presented as n (%) unless stated otherwise.

Abbreviations: SD, standard deviation; ISS, Injury Severity Score; GCS, Glasgow Coma Scale; ED, emergency department.

Table 2 Hospital admission according to injury type

Hospital admission	Facial injuries with other injuries (N=107), n (%)	Facial injuries only (N=83), n (%)	P-value
Total inpatients	68 (63.6)	19 (22.9)
One admission	58 (54.2)	16 (19.3)
Two admissions	9 (8.4)	2 (2.4)	0.46*
Three admissions	0	1 (1.2)
Four admissions	1 (0.9)	0
LOS per admission, days, mean (SD)	7.8 (5.7)	5.8 (2.9)	0.038**
Total outpatients	39 (36.4)	64 (77.1)

Notes:

* Fisher’s exact test;

** Student’s t-test. Data presented as n (%) unless stated otherwise.

Abbreviations: SD, standard deviation; LOS, length of stay.

Table 3 Cost by injury type

Inpatient cost	Facial injuries with other injuries (US$), mean (SD)	Facial injuries only (US$), mean (SD)	P-value
Inpatient cost per admission (per patient until recovery)	1,716.47 (1,230.05)	1,261.96 (630.18)	0.032*

Note:

* Student’s t-test.

Abbreviation: SD, standard deviation.

Table 4 Hospital admission according to injury severity

Hospital admission	Severity
	Mild (N=160), n (%)	Moderate (N=18), n (%)	Severe (N=10), n (%)	Very severe (N=2), n (%)	P-value
Inpatient care
Total inpatients	57 (35.6)	18	10	2
One admission	50 (31.3)	15 (83.3)	8 (80)	1 (50)
Two admissions	7 (4.3)	2 (11.1)	2 (20)	0	0.02*
Three admissions	0	1 (5.6)	0	0
Four admissions	0	0	0	1 (50)
LOS per admission, days, mean (SD)	6.4 (5.7)	9.8 (5.9)	11.2 (5.9)	13.4 (10.5)	0.008**
Outpatients	103 (64.4)	0	0	0

Notes:

* Pearson’s χ²;

** Student’s t-test. Data presented as n (%) unless stated otherwise.

Abbreviations: SD, standard deviation; LOS, length of stay.

Table 5 Inpatient hospital cost according to LOS and injury severity

Inpatient hospital cost	Injury severity
	Mild	Moderate	Severe	Very severe	P-value
Inpatient cost according to LOS (US$), mean (SD)	1,335.23 (1,189.19)	2,044.57 (1,230.91)	2,336.66 (1,230.91)	2,795.64 (2,190.62)	0.007*

Note:

* Analysis of variance. Cost of inpatient US$208.63 per day.

Abbreviations: LOS, length of stay; SD, standard deviation.

Table 6 Costs for various treatments in one of the university hospitals

Type of treatment	Estimated actual cost (US$)	Cost after subsidy (US$)
Wound cleansing and suturing under LA (simple wound) (MAIS 1)	93.80	25.80
Wound cleansing and suturing under LA (complex wound) (MAIS 1 or 2)	110.50	48.40
Wound cleansing and suturing under GA (MAIS 1 or 2)	277.70	161.30
Closed reduction of mandibular fracture under LA (MAIS 1 or 2)	133.80	96.80
Closed reduction of mandibular fracture under GA (MAIS 1 or 2)	300.30	129.00
Open reduction of mandibular fracture under GA (MAIS 1 or 2)	368.00	241.90
Open reduction of zygomatic complex under GA (MAIS 2)	311.60	129.00
Orbital wall/floor fracture open reduction under GA (MAIS 2)	577.70	241.90
Le Fort 1 ORIF under GA (MAIS 2)	351.90	241.90
Le Fort 3 ORIF under GA (MAIS 3)	851.90	241.90

Abbreviations: LA, local anesthesia; MAIS, Maximum Abbreviated Injury Scale; GA, general anesthesia; ORIF, open reduction and internal fixation.