Uterine artery embolization--inpatient and outpatient therapy: a comparison of cost, safety, and patient satisfaction.
OBJECTIVE
To determine whether uterine artery embolization (UAE) can be safely performed as an outpatient procedure without increased complications and readmission rates or decreased patient satisfaction rates and to determine the Canadian cost difference between performing UAE as an outpatient, compared with inpatient, procedure.


METHODS
We performed a retrospective chart review and patient survey of 2 groups of patients, 132 patients who underwent inpatient UAE and 20 patients who underwent outpatient UAE. Of these, 82 and 18, respectively, were successfully surveyed by telephone. Variables examined included presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also performed a detailed Canadian cost analysis comparing inpatient with outpatient UAE.


RESULTS
We did not find any statistically significant difference between inpatient and outpatient UAE on any of the patient variables measured, including presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also found that outpatient UAE costs significantly less than inpatient UAE, primarily owing to decreased hospital overhead costs for overnight admission. In Ontario, inpatient UAE costs per patient totalled dollars 3216.22, whereas outpatient costs totalled dollars 2194.53--a saving of dollars 1021.69, which represents a 31.8% cost reduction.


CONCLUSIONS
Given these results, we recommend that centres consider performing UAE as an outpatient procedure. A key enabling factor is the ability to have several hours of close nursing supervision of the patient postprocedure, prior to discharge.
Baerlocher
Mark O
MO
Radiology Residency Training Program, University of Toronto, ON. mark.baerlocher@utoronto.ca
Asch
Murray R
MR
Hayeems
Eran B
EB
Hayeems
Eran Z
EZ
Rajan
Dheereaj K
DK
D000328:Adult; D000553:Ambulatory Care; D001158:Arteries; D003365:Costs and Cost Analysis; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000191:economics*; D005260:Female; D006760:Hospitalization; D006801:Humans; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012449:Safety; D014599:Uterus / Q000098:blood supply